The goal of this project was to generate and publicise a list of priority topics, for both new and updated reviews, ensuring the involvement of our main stakeholders.
What did we do?
We established a Steering Group including ophthalmologists, optometrists, orthoptists, ophthalmic nurses, relevant professional bodies, consumers and patient organisations, experienced clinical editors, systematic review methodologists, and information specialists.
To identify potential systematic review questions, we first searched global policy reports, other research prioritisation exercises and roadmaps, guidelines, systematic review databases, and intervention studies on The Cochrane Library (CENTRAL). We grouped questions by condition (e.g., cataract, refractive error, glaucoma) and conducted a two-round online Delphi survey to identify priority review questions.
Participants in the online survey were recruited by social media and through the networks of the Steering Group: 343 people took part in Round 1 and 160 took part in both Round 1 and Round 2. Participants included eye care practitioners (69%), researchers (37%), patients and carers (24%), research provider/funders (5%) and non-eye health care practitioner (4%). Participants were from all WHO regions with a majority from the European region (62%).
What did we find?
The top five questions for each condition group are listed below.
What did we find?
The top five questions for each condition group are listed below.
How should prospective review teams use this list?
Proposals for Cochrane Reviews should be submitted to Cochrane following the instructions here.
The review topics listed below may be used as a starting point when developing a proposal for a Cochrane Review. In order to minimise duplication of effort, review author teams need to consider current and past reviews on the topic and ensure that the proposed review is focussed on the key question that can be answered by a systematic review. We advise following the PICO framework for intervention reviews with careful consideration of Population, Interventions, Comparator and Outcome. This framework may be modified for other review types (prognostic reviews - population, index factor, comparator, outcomes, timing and diagnostic test accuracy reviews - population, index test, target condition, setting). A clear idea of the number of available studies likely to be included in the review is also important; reviews with very few or no studies are less likely to be accepted.
Updates of reviews on The Cochrane Library would usually be undertaken by the same review team but there may be opportunities for collaboration in these situations. Work on some of the review topics listed below may be underway. Please contact Alison Liu (suhsun.liu@cuanschutz.edu) prior to developing a proposal to check whether the review question is likely to be available.
Cataract
Question |
Interventions to improve access to, and/or affordability of, cataract surgery |
Interventions to improve training of cataract surgeons and/or support staff |
Interventions to improve monitoring of outcomes after cataract surgery |
Interventions to improve integration of cataract and refractive error services |
Interventions for improving outcomes after complicated cataract surgery |
Refractive Error
Question |
Models to increase uptake and access to refraction and optical services |
Practitioner training for identification of refractive error and vision problems |
Prescribing guidelines for spectacles to improve vision outcomes |
Prognostic factors for the development and progression of refractive error |
Interventions for presbyopia |
A number of participants highlighted the importance of assessing the evidence for interventions to halt or slow down the progression of myopia, particularly in children. This question has not been included in the top five list of questions because a new Cochrane review on this topic will be published in January 2023. This will be a "living systematic review" which means that the review authors plan to search the literature every six months and incorporate new evidence as it becomes available.
Diabetic retinopathy
Question |
Integration of diabetic eye care services within the health service |
Barriers that prevent diabetic patients having regular eye checks |
Interventions to increase attendance for diabetic retinopathy screening |
Artificial intelligence for screening and/or diagnosis of diabetic retinopathy |
Non-invasive treatments for slowing down progression of diabetic retinopathy |
Glaucoma
Question |
Monitoring glaucoma to prevent progression, including with telemetry |
Interventions to improve the referral pathway for glaucoma |
Prognostic risk factors for glaucoma development and progression |
Artificial intelligence for screening and/or diagnosis of glaucoma |
Optical coherence tomography for the diagnosis and monitoring of glaucoma |
Macular disease
Question |
Safety and efficacy of different drug delivery systems for treatment of AMD |
Interventions to improve the capacity and productivity of wet AMD pathways |
Telemedicine for the diagnosis and monitoring of AMD |
Educational interventions for wellbeing/quality of life for people with AMD |
Prognostic factors for the development and progression of AMD |
Other retinal conditions
Question |
Prognostic factors for the outcome of surgery for epiretinal membranes |
Interventions to reduce risk of sight loss in retinal detachments |
Wide-angle imaging to detect retinal detachment in non-eyecare settings |
Interventions to prevent proliferative vitreoretinopathy in retinal detachment surgery |
Prognostic factors for visual loss in inherited retinal diseases |
Ocular surface
Question |
Interventions for dry eye |
Interventions for corneal diseases/dystrophies |
Interventions to improve the outcomes of corneal transplantation |
Prognostic factors for development of dry eye syndrome, including biomarkers |
Diagnostic tests for dry eye syndrome, including biomarkers |
Eyelid and lacrimal system
Question |
Interventions for lacrimal duct obstruction |
Interventions for ptosis |
Interventions for cancers involving the eyelid |
Interventions for blepharitis and meibomian gland dysfunction |
Interventions for entropion |
Neuro-ophthalmology
Question |
Interventions for optic neuritis not associated with multiple sclerosis |
Prognostic factors for visual field loss in acquired brain injury |
Screening for cerebral visual impairment |
Interventions for idiopathic intracranial hypertension |
Prognostic factors for vision loss in intracranial hypertension |
Infection and inflammation
Question |
Prevention of corneal infections in contact lens wearers |
Interventions for infectious uveitis |
Interventions for non-infectious uveitis |
Prognostic factors for the development and progression of uveitis |
Interventions for the prevention and treatment of recurrent ophthalmic herpes |
Children
Question |
School vision screening programmes (methods and impact) |
Prognostic factors for development/ progression of refractive error in children |
Screening for amblyopia during vaccination programs for rural communities |
Interventions for amblyopia |
Screening for retinoblastoma |
A number of participants highlighted questions relating to screening and treatment of retinopathy of prematurity. These questions have not been included in the top five list of questions here because retinopathy of prematurity is within the scope of Cochrane Neonatal rather than Cochrane Eyes and Vision.
Rehabilitation
Question |
Interventions to improve access and affordability of visual rehabilitation |
Models of rehabilitation including integration with eye care |
Assistive technology for adults and children with low vision |
Psychological interventions to support living with visual impairment |
Impact of vision loss on quality life |
General
Question |
Telemedicine to improve referral from primary to secondary care |
Artificial intelligence to improve referral from primary to secondary care |
Models for out-of-hours emergency eye care |
Simultaneous detection of all major eye conditions |
Diagnosis and management of eye disease by non-ophthalmologists |