Integrating Research, Clinical Expertise, and Patient-Centered Care in Optometry: a Critical Review of Evidence-Based Practice Standards and Barriers to Implementation

Abstract

Evidence-based practice (EBP) is a foundational paradigm in modern healthcare, and its adoption in optometry is essential for delivering high-quality, consistent, and patient-centered care. EBP in optometry integrates three key components: the best available research evidence, the clinical expertise of the practitioner, and the values and preferences of the patient. This review critically examines the current landscape of EBP in optometry, focusing on the implementation of these components in clinical settings, the methodologies supporting evidence-informed decision-making, and the barriers hindering full integration into practice. Despite growing recognition of EBP’s value, optometrists face significant challenges, including a lack of high-quality, optometry-specific research, inconsistent EBP training across educational programs, limited access to resources, and resistance to change. Additional obstacles include time constraints and misaligned policy or reimbursement structures. The article explores foundational tools supporting EBP, such as the PICO framework, clinical practice guidelines, decision-support technologies, and systematic reviews, evaluating their role in improving care quality. Using real-world clinical case studies in myopia control, dry eye management, glaucoma treatment, and diabetic retinopathy screening, the review highlights the practical benefits of EBP. It also identifies opportunities to advance EBP, including educational reform, practice-based research networks, artificial intelligence integration, and policy advocacy for evidence-driven care. Ultimately, this article advocates for a cohesive model of optometric care that bridges the gap between research and practice, supports professional development, and centers patients in clinical decision-making. Strengthening EBP in optometry will enhance patient outcomes and advance the profession in an evolving healthcare landscape.