Author’s Disclosure Block: Victoria Liu, none; Fred Feng, none; Danah Albreiki, none; Daniel Lelli, none; Matthew Quinn, none

Abstract Body
Purpose:To understand the diversity of practice patterns and perceptions of Canadian optometrists and neurologists related to the diagnosis and management of CRAO. Study Design: Nation-wide cross sectional, online, survey study. Methods: Two surveys were distributed nation-wide between March 15thto May 1st2024. Surveys were formulated using a ‘Think Aloud’ audit process to ensure quality and comprehensiveness. One survey was distributed through the Canadian Association of Optometrists, aiming to assess optometry practice patterns including time to response, frequency of diagnosis, and management patterns. A second survey was disseminated through academic neurology programs via program administrator and through the Canadian Stroke Consortium. The aim of this survey was to assess neurologist practice considerations including previous use of and willingness to offer thrombolysis in CRAO, and the need for diagnostic tests and ophthalmological consult. Survey data was collected in a standardized collection form. Quantitative data was analyzed using descriptive statistics. Results: One hundred and thirty-three optometrists and 64 neurologists responded to the surveys. Most optometrists responded that they would see someone who seeks care for sudden vision loss immediately or in 24 hours (94%). A minority (7%) of optometrists reported they were never comfortable monitoring for neovascularization or sequalae post CRAO, whereas approximately half (49%) reported they were often or always comfortable with monitoring for ocular complications. Of the 64 neurology respondents, 70% reported fellowship training in stroke. Over half of the respondents reported never having provided thrombolysis for the treatment of isolated non-arteritic CRAO. Most neurologists (87%) chose that CT head imaging was essential prior to consideration of thrombolysis for CRAO. An ophthalmology consult was identified as necessary component in all cases by over half of the respondents, however, approximately 40% of these respondents noted that virtual consultation would suffice. Conclusions: This is the first Canadian study to examine practice patterns and perceptions of CRAO management among neurologists and optometrists. This survey demonstrates reasonable response timing for optometrists, yet room for further education regarding the monitoring of neovascular sequelae to enhance comfort and guide referral patterns. Among neurologists, there was a willingness to provide thrombolysis, yet limited experience. Ophthalmology support was identified as being necessary in most cases of suspected CRAO to facilitate thrombolysis management, however, virtual consultation would be accepted by most providers, perhaps through emergency department fundus photos. These survey findings help to understand multidisciplinary practice patterns to develop educational strategies and inform future frameworks to guide optimal care for patients with CRAO.