{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:07:53Z","timestamp":1772168873196,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.159132.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000}}],"reference-count":42,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Background The burden of visual impairment and avoidable blindness has been attributed to the shortage and poor distribution of adequately trained eye care personnel. In the district health system, primary health care (PHC) nurses are the first point of contact for eye care patients. To provide adequate eye care, the nurses in PHC clinics apply their knowledge on basic eye health to ensure best practices and management for patients that present at their clinics. Anecdotal evidence regarding the knowledge and practices of these PHC professionals is scarce. The purpose of this study was to evaluate PHC nurses\u2019 knowledge and practices on eye health. Methods A quantitative, cross-sectional study was conducted in a rural district of the Eastern Cape Province in South Africa. Stratified random sampling was used to select 28 from the 74 PHC clinics in the district. A researcher-administered questionnaire using a 5-point likert scale with options strongly disagree, disagree, neutral, agree and strongly agree, was developed, piloted and finalised for this study. The tool had four sections: demographic information, knowledge of eye health, practices on evaluating visual function and identification and management of presenting eye conditions. Data were collected, captured onto MSXcel, cleaned, coded and analysed descriptively, and for Chi-squared significance at 95%, using R statistical software. Results From 200 responses, 86.4% (n=172) were females of the African race. Most (93.5%, n=187) had never undergone formal training in eye care. Only 28% (n=56) correctly identified a mature cataract while 28% (n=56) correctly identified signs of glaucoma; the global leading causes of preventable blindness. A total of 94% (n=188) failed to accurately measure visual acuity on a patient. Conclusions PHC nurses showed poor knowledge and practices of common eye conditions. There is an urgent need for eye health training for PHC nurses, and the clear management protocols on eye care.<\/ns3:p>","DOI":"10.12688\/f1000research.159132.2","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T11:39:09Z","timestamp":1769254749000},"page":"1530","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing eye health knowledge and practices amongst primary health care nurses in a rural district, South Africa\u202f\u202f"],"prefix":"10.12688","volume":"13","author":[{"given":"Lwandile","family":"Flatela","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2729-8639","authenticated-orcid":false,"given":"Zamadonda N","family":"Xulu-Kasaba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1036-1042","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050.","volume":"123","author":"B Holden","year":"2016","journal-title":"Ophthalmology."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e489-e551","DOI":"10.1016\/S2214-109X(20)30488-5","article-title":"The Lancet global health Commission on global eye health: vision beyond 2020.","volume":"9","author":"M Burton","year":"2021","journal-title":"Lancet Glob. 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Without establishing this foundational context, the introduction misses an opportunity to highlight the broader implications of inadequate ocular awareness among nursing professionals. <\/b><\/i>  This is what the study sought to assess, the knowledge of nurses on eye health and their practices. As such, it was not possible to discuss what the study was trying to assess in the introduction. This is why the knowledge is discussed under the Discussion section, after results had been obtained.  \n<b><i>2 Furthermore, the tools used to assess knowledge and practices appear to lack sufficient validation, raising concerns about the reliability and interpretability of the results.<\/i><\/b>  Albeit not statistically validated, all tools were piloted in another province as stated in the Methodology section under \u201cData collection, processing and analysis\u201d. Through this process, amendments were made, the tool refined and finalised for the study.","URL":"https:\/\/f1000research.com\/articles\/13-1530\/v2#referee-comment-15291","order":2,"name":"referee-comment-15291","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.174818.r397069, Benoit Tousignant, University of Montreal, Montreal, 22 Aug 2025, version 1, 3 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/13-1530\/v1#referee-response-397069","order":3,"name":"referee-response-397069","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Zamadonda Xulu-Kasaba<\/b>; \n<i>Posted: 17 Jan 2026<\/i>; \n<i><b>No.<\/b> <b>Query<\/b><\/i> Response to Query  \n<i><b>1 The authors present an interesting study on the knowledge and practice levels of primary care nurses with regard to eye care in rural South Africa.&nbsp; Some revisions are required to strengthen the manuscript.  - In Study design, when first mentioning the PI, include that person's initials in parentheses<\/b><\/i>  Initials of the PI have been included with the first mention.  \n<i><b>2 - &quot;African race&quot; is used throughout abstract and manuscript.&nbsp; consider reviewing and referring to specific South African ethnicities of the participants, rather than a too general term  - references should include WHO World report on vision (2019), in addition to refs 1-5 - instead of ref 6, use WHO Eye care competency framework.&nbsp; Adapt and rephrase manuscript accordingly, using wording form that document.<\/b><\/i>   African is the least offensive term that is agreeable with ethnic people in Africa generally. This is why it was preferred in relation to \u201cBlacks\u201d. Other terms would have been tribalistic, which is a contentious issue now in South Africa. As such, \u201cAfrican\u201d was the best option.  Ref 2 (2021) contains updated data from the World report on vision (2019). We opted to use the latest available values.  \n<i><b>3 - Data collection: 2nd line, missing word: &quot;...at most sites due TO absenteeism&quot;<\/b><\/i>   Thank you, corrected.  \n<i><b>4 - a copy of the questionnaire is required<\/b><\/i>   At the end of the manuscript, under \u201cData availability statement\u201d there is a link that leads to a repository with the questionnaire and other data for the study. The journal asks that it be placed in this online repository.   \n<i><b>- methods should specify how analysis was made with Likert: how were neutral responses handled?<\/b><\/i>  Thank you, this has been addressed with the addition of a paragraph detailing it at the end of the methods section.  \n<i><b>- Results section generally: the text should briefly report highlights of results and then refer to Tables 3-4-5 for the complete results.&nbsp;<\/b><\/i>  Noted, thank you.  \n<i><b>-&nbsp;Tables 3 and 5: add note to say which stat test the p-values refer to (chi-square?)<\/b><\/i>  Noted and addressed.  \n<i><b>- methods (relating to results presented in Table 5: include example of cataract (or other condition) pictures used to test knowledge and practice?&nbsp; how were these pictures or knowledge items selected, and by whom?<\/b><\/i>  As detailed under \u201cData collection, processing and analysis\u201d, the tool was developed using various primary health guidelines and screening documents. Coloured pictures were selected from those documents by the researchers in the study. These are all in the suppository and available for anyone to see. Next to each picture was a statement on naming the condition e.g. this is a mature cataract accompanied by the 5 category Likert Scale, then there would be a second question e.g. It requires an immediate transfer to a hospital, with the respondent indicating again from Strongly agree to disagree.  \n<i><b>- manuscript would benefit from a deeper analysis, including additional analyses such as looking at associations between % of correct knowledge and age, sex, type of institution, job title, duration of service. Use non-parametric tests as need if cell counts are below 5.&nbsp; Repeat these analyses for % of correct practice.&nbsp; Report carefully, given the small numbers of certain cells\/subgroups.<\/b><\/i>  Tables 3, 4 and 5 have given most of the suggested information. Associations relating to gender, type of institution and job title became redundant when we tried them due to the fact that almost 100% of the participants shared the same characteristics e.g. all were females, working at the same type of institution with the same job title. Otherwise, thank you for the input, it is worth remembering for future data analysis and discussion.","URL":"https:\/\/f1000research.com\/articles\/13-1530\/v2#referee-comment-15290","order":4,"name":"referee-comment-15290","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}