<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2504-3145</journal-id>
<journal-title><![CDATA[Portuguese Journal of Public Health]]></journal-title>
<abbrev-journal-title><![CDATA[Port J Public Health]]></abbrev-journal-title>
<issn>2504-3145</issn>
<publisher>
<publisher-name><![CDATA[Escola Nacional de Saúde Pública]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2504-31452023000200111</article-id>
<article-id pub-id-type="doi">10.1159/000530060</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Integration of refractive services provided by optometrists into the portuguese national health service]]></article-title>
<article-title xml:lang="pt"><![CDATA[Integração de serviços refrativos prestados por optometristas no serviço nacional de saúde português]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carneiro]]></surname>
<given-names><![CDATA[Vera L. Alves]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González-Méijome]]></surname>
<given-names><![CDATA[José Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,University of Minho School of Sciences Clinical and Experimental Optometry Research Lab (CEORLab) - Center of Physics]]></institution>
<addr-line><![CDATA[Braga ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2023</year>
</pub-date>
<volume>41</volume>
<numero>2</numero>
<fpage>111</fpage>
<lpage>121</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2504-31452023000200111&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2504-31452023000200111&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2504-31452023000200111&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Refractive error is a public health concern and even with relatively simple and cost-effective interventions it remains usually outside national health services (NHSs) not ensuring universal health coverage. This study aimed to generate evidence about the availability and accessibility of refractive services in Portugal and to present a plan for more efficient services.  Methods:  A situation analysis of the Portuguese existing refractive services within the NHS was conducted based on three health systems building blocks: service delivery access, service coverage, and workforce. A strengths, weaknesses, opportunities, and threats analysis was performed based on existent evidence to identify internal and external factors that can facilitate or hinder the integration of refractive services within the NHS. The number of eye care personnel to be integrated in the NHS was calculated considering the minimum ratios recommended by national and international technical reports.  Results:  Portugal has no specific services to address refractive errors within the NHS. Treatment of refractive error occurs at the level of eye care general services. There are 39 NHS eye care services, all hospital-centred and divided into three large groups, according to technical differentiation, the technology required, and workforce capacity. The workforce available is composed of ophthalmologists and orthoptists, together with nurses and other general paramedical assistants. 3 Portuguese municipalities have more than 1 NHS eye care service, 35 have 1 NHS eye care service, and 240 municipalities (in the mainland) have none. In 2021, 52% of the hospitals providing eye care services did not meet the recommended response times. Centralization of eye care services in urban areas, undifferentiated referral systems, and a shortage in the workforce per inhabitant was observed.  Conclusions:  Portuguese NHS has all the requirements to reorientate refractive care from the current hospital-based model to primary care. The country also has a trained and qualified workforce to address this condition. Evidence demonstrates that the provision of refractive services at primary care is efficient and effective and translates into an opportunity to identify other visual conditions.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  O erro refrativo é um problema de saúde pública, mas mesmo com intervenções tecnicamente simples e com ótimo custo-benefício, permanece numa abordagem fora do serviço nacional de saúde (SNS) e sem garantias de cobertura universal. Este estudo pretendeu gerar evidência sobre a disponibilidade e acessibilidade de serviços refrativos em Portugal e apresentar um plano de ação para tornar estes serviços mais eficientes e equitativos.  Métodos:  Foi efetuada uma análise da situação e de prioridades aos serviços refrativos existentes no SNS português baseada em três blocos de construção dos sistemas de saúde: acesso, cobertura e força de trabalho. Uma análise SWOT baseada na evidência foi executada para identificar fatores internos e externos que pudessem facilitar ou comprometer a integração destes serviços. O número de profissionais a integrar foi calculado tendo em consideração os rácios mínimos recomendados.  Resultados:  Portugal não possui serviços específicos para o erro refrativo no SNS. A sua abordagem ocorre ao nível dos cuidados gerais de saúde da visão. Existem 39 serviços de cuidados de saúde da visão no SNS, todos centrados em meio hospitalar e que se dividem em três grandes grupos de acordo com a diferenciação técnica, tecnologia existente e capacidade da força de trabalho. A força de trabalho é composta por médicos oftalmologistas e ortoptistas, juntamente com enfermeiros e outros assistentes paramédicos. 3 concelhos portugueses têm mais do que 1 serviço de cuidados de saúde da visão no SNS, 35 têm apenas 1 e 240 concelhos não possuem qualquer serviço público de cuidados de saúde da visão (todos em Portugal continental). Em 2021, 52% dos hospitais que prestam cuidados de saúde da visão não respeitavam os tempos recomendados. A centralização dos cuidados de saúde da visão em zonas urbanas e litorais, um sistema de referenciação não diferenciado e escassez de força de trabalho são observados.  Conclusão:  O SNS português tem as condições necessárias para a reorientação dos cuidados refrativos do atual modelo hospitalar para os cuidados primários. O país possui força de trabalho treinada e qualificada para gerir esta condição. A evidência demonstra que disponibilizar serviços refrativos nas unidades de cuidados primários é eficiente, seguro e traduz-se numa oportunidade para identificação de outras condições visuais.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Refractive error]]></kwd>
<kwd lng="en"><![CDATA[Refractive services]]></kwd>
<kwd lng="en"><![CDATA[Portugal]]></kwd>
<kwd lng="en"><![CDATA[Eye care]]></kwd>
<kwd lng="en"><![CDATA[National health service]]></kwd>
<kwd lng="pt"><![CDATA[Erro refractivo]]></kwd>
<kwd lng="pt"><![CDATA[Serviços refractivos]]></kwd>
<kwd lng="pt"><![CDATA[Portugal]]></kwd>
<kwd lng="pt"><![CDATA[Cuidados para a saúde da visão]]></kwd>
<kwd lng="pt"><![CDATA[Serviço Nacional de Saúde]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<collab>GBD 2019 Blindness and Vision Impairment Collaborators</collab>
<article-title xml:lang=""><![CDATA[Vision Loss Expert Group of the Global Burden of Disease Study. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study]]></article-title>
<source><![CDATA[Lancet Glob Health]]></source>
<year>2021</year>
<volume>9</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>e144-60</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<collab>Portugal. Ministério da Saúde</collab>
<collab>Direção Geral de Saúde</collab>
<source><![CDATA[Estratégia Nacional para a Saúde da Visão]]></source>
<year>2018</year>
<publisher-loc><![CDATA[Lisboa ]]></publisher-loc>
<publisher-name><![CDATA[Direção Geral de Saúde]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carneiro]]></surname>
<given-names><![CDATA[VLA]]></given-names>
</name>
<name>
<surname><![CDATA[González-Méijome]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence of refractive error in Portugal a systematic review and meta-analysis]]></article-title>
<source><![CDATA[J Optom]]></source>
<year>2022</year>
<volume>16</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>182-8</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[World report on vision]]></source>
<year>2019</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Burton]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Ramke]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Marques]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
<name>
<surname><![CDATA[Bourne]]></surname>
<given-names><![CDATA[RRA]]></given-names>
</name>
<name>
<surname><![CDATA[Congdon]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Jones]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The lancet global health commission on global eye health vision beyond 2020]]></article-title>
<source><![CDATA[Lancet Glob Health]]></source>
<year>2021</year>
<volume>9</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>e489-551</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tanahashi]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Health service coverage and its evaluation]]></article-title>
<source><![CDATA[Bull World Health Organ]]></source>
<year>1978</year>
<volume>56</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>295-303</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Shengelia]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Tandon]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Adams]]></surname>
<given-names><![CDATA[OB]]></given-names>
</name>
<name>
<surname><![CDATA[Murray]]></surname>
<given-names><![CDATA[CJL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Access, utilization, quality, and effective coverage an integrated conceptual framework and measurement strategy]]></article-title>
<source><![CDATA[Soc Sci Med]]></source>
<year>2005</year>
<volume>61</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>97-109</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Thiede]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Akweongo]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[McIntyre]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Exploring the dimensions of access]]></article-title>
<source><![CDATA[The economics of health equity]]></source>
<year>2007</year>
<page-range>10323</page-range><publisher-loc><![CDATA[Cambridge ]]></publisher-loc>
<publisher-name><![CDATA[Cambridge University Press]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ghebreyesus]]></surname>
<given-names><![CDATA[TA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Using behavioural science for better health]]></article-title>
<source><![CDATA[Bull World Health Organ]]></source>
<year>2021</year>
<volume>99</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>755</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mas-Tur]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Jawaid]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Poostchi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Verma]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Optometrist referrals to an emergency ophthalmology department a retrospective review to identify current practise and development of shared care working strategies, in England]]></article-title>
<source><![CDATA[Eye]]></source>
<year>2021</year>
<volume>35</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1340-6</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gunn]]></surname>
<given-names><![CDATA[PJG]]></given-names>
</name>
<name>
<surname><![CDATA[Creer]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
<name>
<surname><![CDATA[Bowen]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Tromans]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Jackson]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Tompkin]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Scope of practice of optometrists working in the UK Hospital Eye Service second national survey]]></article-title>
<source><![CDATA[Ophthalmic Physiol Opt]]></source>
<year>2022</year>
<volume>42</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>428-39</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Harper]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Creer]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
<name>
<surname><![CDATA[Jackson]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ehrlich]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Tompkin]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
<name>
<surname><![CDATA[Bowen]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Scope of practice of optometrists working in the UK Hospital Eye Service a national survey]]></article-title>
<source><![CDATA[Ophthalmic Physiol Opt]]></source>
<year>2016</year>
<volume>36</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>197-206</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Parkins]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Curran]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Pooley]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Ryan]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The developing role of optometrists as part of the NHS primary care team]]></article-title>
<source><![CDATA[Optom Pract]]></source>
<year>2014</year>
<volume>15</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>177-84</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cameron]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Ahmed]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Curry]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Forrest]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Sanders]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impact of direct electronic optometric referral with ocular imaging to a hospital eye service]]></article-title>
<source><![CDATA[Eye]]></source>
<year>2009</year>
<volume>23</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1134-40</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Murta]]></surname>
<given-names><![CDATA[JN]]></given-names>
</name>
</person-group>
<source><![CDATA[Rede Nacional de Especialidade e de Referenciação em Oftalmologia]]></source>
<year>2016</year>
<publisher-loc><![CDATA[Lisboa ]]></publisher-loc>
<publisher-name><![CDATA[Direção Geral de Saúde. Ministério da Saúde]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B16">
<label>16.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lourenço]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Barros]]></surname>
<given-names><![CDATA[PP]]></given-names>
</name>
</person-group>
<source><![CDATA[Cuidados de saúde da visão: estudo para a universalização de cuidados de saúde da visão em Portugal: estudo realizado por solicitação da Associação de Profissionais Licenciados de Optometria]]></source>
<year>2019</year>
<publisher-loc><![CDATA[Lisboa ]]></publisher-loc>
<publisher-name><![CDATA[NOVA School of Business &amp; Economics]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Keel]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Müller]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Block]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Bourne]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Burton]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Chatterji]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Keeping an eye on eye care monitoring progress towards effective coverage]]></article-title>
<source><![CDATA[Lancet Glob Health]]></source>
<year>2021</year>
<volume>9</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>e1460-4</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[Eye care situation analysis tool (ECSAT)]]></source>
<year>2022</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[Global initiative for the elimination of avoidable blindness: action plan 2006-2011]]></source>
<year>2007</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Maake]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Moodley]]></surname>
<given-names><![CDATA[VR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An evaluation of the public sector optometric service provided within the health districts in KwaZulu-Natal, South Africa]]></article-title>
<source><![CDATA[Afr Vis Eye Health]]></source>
<year>2018</year>
<volume>77</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>9</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="">
<collab>Portugal. Ministério da Saúde</collab>
<collab>Serviços Partilhados do Ministério da Saúde</collab>
<source><![CDATA[Tempos médios de espera. Lisboa; SPMS]]></source>
<year>2021</year>
</nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ingram]]></surname>
<given-names><![CDATA[DV]]></given-names>
</name>
<name>
<surname><![CDATA[Culham]]></surname>
<given-names><![CDATA[LE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ophthalmologists and optometrists interesting times]]></article-title>
<source><![CDATA[Br J Ophthalmol]]></source>
<year>2001</year>
<volume>85</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>769-70</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wright]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Delayed attendance at routine eye examinations is associated with increased probability of general practitioner referral a record linkage study in Northern Ireland]]></article-title>
<collab>O'Reilly D.Azuara-Blanco A.Curran R.McMullan M.Hogg RE</collab>
<source><![CDATA[Ophthalmic Physiol Opt]]></source>
<year>2020</year>
<volume>40</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>365-75</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[MIC]]></given-names>
</name>
<name>
<surname><![CDATA[Sos]]></surname>
<given-names><![CDATA[Franco]]></given-names>
</name>
</person-group>
<source><![CDATA[25 anos da Optometria e das ciências da visão na Universidade do Minho: a construção de um paradigma]]></source>
<year>2016</year>
<publisher-loc><![CDATA[Braga, Portugal ]]></publisher-loc>
<publisher-name><![CDATA[Universidade de Minho]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carneiro]]></surname>
<given-names><![CDATA[VLA]]></given-names>
</name>
<name>
<surname><![CDATA[Jorge]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Competencies and training needs of the Portuguese optometrists a national inquiry]]></article-title>
<source><![CDATA[J Optom]]></source>
<year>2020</year>
<volume>13</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>88-95</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[The World Health Report 2008: primary health care now more than ever]]></source>
<year>2008</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[Strategies for the prevention of blindness in national programmes: a primary health care approach]]></source>
<year>1997</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Naidoo]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Ravilla]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Delivering refractive error services primary eye care centres and outreach]]></article-title>
<source><![CDATA[Community Eye Health]]></source>
<year>2007</year>
<volume>20</volume>
<numero>63</numero>
<issue>63</issue>
<page-range>42-4</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Biscaia]]></surname>
<given-names><![CDATA[AR]]></given-names>
</name>
<name>
<surname><![CDATA[Heleno]]></surname>
<given-names><![CDATA[LC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Primary health care reform in Portugal Portuguese, modern and innovative]]></article-title>
<source><![CDATA[Cien Saude Colet]]></source>
<year>2017</year>
<volume>22</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>701-12</page-range></nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cochrane]]></surname>
<given-names><![CDATA[GM]]></given-names>
</name>
<name>
<surname><![CDATA[du Toit]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Le Mesurier]]></surname>
<given-names><![CDATA[RT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Management of refractive errors]]></article-title>
<source><![CDATA[BMJ]]></source>
<year>2010</year>
<volume>340</volume>
<numero>apr</numero>
<issue>apr</issue>
</nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Muñoz]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[West]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Rodriguez]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Sanchez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Broman]]></surname>
<given-names><![CDATA[AT]]></given-names>
</name>
<name>
<surname><![CDATA[Snyder]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Blindness, visual impairment and the problem of uncorrected refractive error in a Mexican-American population proyecto VER]]></article-title>
<source><![CDATA[Invest Ophthalmol Vis Sci]]></source>
<year>2002</year>
<volume>43</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>608-14</page-range></nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Smith]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Frick]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Holden]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Fricke]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Naidoo]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Potential lost productivity resulting from the global burden of uncorrected refractive error]]></article-title>
<source><![CDATA[Bull World Health Organ]]></source>
<year>2009</year>
<volume>87</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>431-7</page-range></nlm-citation>
</ref>
<ref id="B33">
<label>33</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fricke]]></surname>
<given-names><![CDATA[TR]]></given-names>
</name>
<name>
<surname><![CDATA[Holden]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
<name>
<surname><![CDATA[Wilson]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
<name>
<surname><![CDATA[Schlenther]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Naidoo]]></surname>
<given-names><![CDATA[KS]]></given-names>
</name>
<name>
<surname><![CDATA[Resnikoff]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Global cost of correcting vision impairment from uncorrected refractive error]]></article-title>
<source><![CDATA[Bull World Health Organ]]></source>
<year>2012</year>
<volume>90</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>728-38</page-range></nlm-citation>
</ref>
<ref id="B34">
<label>34</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Naidoo]]></surname>
<given-names><![CDATA[KS]]></given-names>
</name>
<name>
<surname><![CDATA[Jaggernath]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Uncorrected refractive errors]]></article-title>
<source><![CDATA[Indian J Ophthalmol]]></source>
<year>2012</year>
<volume>60</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>432-7</page-range></nlm-citation>
</ref>
<ref id="B35">
<label>35</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[Monitoring the building blocks of health systems: a handbook on indicators and their measurement strategies]]></source>
<year>2010</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B36">
<label>36</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Schmets]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Rajan]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Kadandale]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
</person-group>
<source><![CDATA[Strategizing national health in the 21st century: a handbook]]></source>
<year>2016</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B37">
<label>37</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Schmets]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Rajan]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Kadandale]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Priority-setting for national health policies, strategies and plans]]></article-title>
<source><![CDATA[Strategizing national health in the 21st century: a handbook]]></source>
<year>2016</year>
<page-range>159231</page-range><publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B38">
<label>38</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Holden]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
<name>
<surname><![CDATA[Resnikoff]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The role of optometry in vision 2020]]></article-title>
<source><![CDATA[Community Eye Health]]></source>
<year>2002</year>
<volume>15</volume>
<numero>43</numero>
<issue>43</issue>
<page-range>33-6</page-range></nlm-citation>
</ref>
<ref id="B39">
<label>39</label><nlm-citation citation-type="book">
<collab>International Agency for the Prevention of Blindness</collab>
<source><![CDATA[Global action plan indicators: the data in full: IAPB vision atlas]]></source>
<year>2017</year>
<publisher-loc><![CDATA[London ]]></publisher-loc>
<publisher-name><![CDATA[The International Agency for the Prevention of Blindness (IAPB)]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B40">
<label>40</label><nlm-citation citation-type="book">
<collab>Portugal. Ministério da Saúde</collab>
<source><![CDATA[Administração Central do Sistema de Saúde Primários]]></source>
<year>2021</year>
<publisher-loc><![CDATA[Lisboa ]]></publisher-loc>
<publisher-name><![CDATA[administração Central do Sistema de Saúde (ACSS)]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B41">
<label>41</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[Package of eye care interventions]]></source>
<year>2022</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B42">
<label>42</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[Declaration of Alma ata]]></source>
<year>1978</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B43">
<label>43</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Banes]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Culham]]></surname>
<given-names><![CDATA[LE]]></given-names>
</name>
<name>
<surname><![CDATA[Bunce]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Xing]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Viswanathan]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Garway-Heath]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Agreement between optometrists and ophthalmologists on clinical management decisions for patients with glaucoma]]></article-title>
<source><![CDATA[Br J Ophthalmol]]></source>
<year>2006</year>
<volume>90</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>579-85</page-range></nlm-citation>
</ref>
<ref id="B44">
<label>44</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Prasad]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kamath]]></surname>
<given-names><![CDATA[GG]]></given-names>
</name>
<name>
<surname><![CDATA[Jones]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Clearkin]]></surname>
<given-names><![CDATA[LG]]></given-names>
</name>
<name>
<surname><![CDATA[Phillips]]></surname>
<given-names><![CDATA[RP.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effectiveness of optometrist screening for diabetic retinopathy using slit-lamp biomicroscopy]]></article-title>
<source><![CDATA[Eye]]></source>
<year>2001</year>
<volume>15</volume>
</nlm-citation>
</ref>
<ref id="B45">
<label>45</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Baker]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Ratnarajan]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Harper]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Edgar]]></surname>
<given-names><![CDATA[DF]]></given-names>
</name>
<name>
<surname><![CDATA[Lawrenson]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effectiveness of UK optometric enhanced eye care services a realist review of the literature]]></article-title>
<source><![CDATA[Ophthalmic Physiol Opt]]></source>
<year>2016</year>
<volume>36</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>545-57</page-range></nlm-citation>
</ref>
<ref id="B46">
<label>46</label><nlm-citation citation-type="book">
<collab>Pordata</collab>
<source><![CDATA[SNS Estabelecimentos de saúde: continente]]></source>
<year>2021</year>
<publisher-loc><![CDATA[Lisboa ]]></publisher-loc>
<publisher-name><![CDATA[Fundação Francisco Manuel dos Santos]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B47">
<label>47</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tahhan]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Papas]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Fricke]]></surname>
<given-names><![CDATA[TR]]></given-names>
</name>
<name>
<surname><![CDATA[Frick]]></surname>
<given-names><![CDATA[KD]]></given-names>
</name>
<name>
<surname><![CDATA[Holden]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Utility and uncorrected refractive error]]></article-title>
<source><![CDATA[Ophthalmology]]></source>
<year>2013</year>
<volume>120</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1736-44</page-range></nlm-citation>
</ref>
<ref id="B48">
<label>48</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fricke]]></surname>
<given-names><![CDATA[TR]]></given-names>
</name>
<name>
<surname><![CDATA[Tahhan]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Resnikoff]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Papas]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Burnett]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ho]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Global prevalence of presbyopia and vision impairment from uncorrected presbyopia systematic review, meta-analysis, and modelling]]></article-title>
<source><![CDATA[Ophthalmology]]></source>
<year>2018</year>
<volume>125</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1492-9</page-range></nlm-citation>
</ref>
<ref id="B49">
<label>49</label><nlm-citation citation-type="book">
<collab>United Nations</collab>
<source><![CDATA[General assembly resolution A/75/L. 108: vision for everyone; accelerating action to achieve the sustainable development goals]]></source>
<year>2021</year>
<publisher-loc><![CDATA[New York, NY ]]></publisher-loc>
<publisher-name><![CDATA[United Nations]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B50">
<label>50</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Keel]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Evans]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Block]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Bourne]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Calonge]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Cheng]]></surname>
<given-names><![CDATA[CY]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Strengthening the integration of eye care into the health system methodology for the development of the WHO package of eye care interventions]]></article-title>
<source><![CDATA[BMJ Open Ophthalmol]]></source>
<year>2020</year>
<volume>5</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
