Challenges and Attitudes to Practising Primary Eye Care Among Malaysian Private Optometrists: Findings from the CAPEC Questionnaire

Abstract

Background: Primary Eye Care (PEC) is an essential component of preventive eye health, yet its implementation in Malaysia’s private optometry sector remains limited. Building upon a previously validated instrument (CAPEC questionnaire), this study aimed to assess the current challenges and attitudes of private optometrists towards practising PEC, and to identify factors associated with these domains. Methods: A cross-sectional online survey was conducted among optometrists practising in Malaysian private settings from May to October 2021. Respondents completed the validated Challenges and Attitudes to Practice Primary Eye Care (CAPEC) questionnaire, consisting of 34 items across six domains: four domains of challenges (working environment, support and recognition, self-sufficiency, and customer influence) and two domains of attitudes (motivation and sense of responsibility). Descriptive statistics, MANOVA, and multiple linear regression were used to explore domain differences and associations between challenges and attitudes. Results: A total of 291 optometrists participated. Among the challenge domains, support and recognition recorded the highest mean score (M = 3.57, SD = 0.53), indicating substantial barriers due to limited institutional acknowledgement and professional recognition. Attitudes toward PEC were generally high, particularly for sense of responsibility (M = 4.58, SD = 0.42). Factorial MANOVA revealed that practice ownership significantly influenced perceived challenges (p = 0.027), where practice owners reported higher barriers in support and recognition. Multiple linear regression analysis demonstrated that support and recognition, self-sufficiency, and customer influence significantly predicted the overall attitudes toward implementing PEC (p < 0.001). Conclusion: Despite facing considerable challenges, Malaysian private-sector optometrists exhibit strong motivation and a high sense of responsibility towards PEC. Strengthening institutional support, recognition frameworks, and continuing professional development opportunities could accelerate PEC adoption in private practices, ultimately enhancing nationwide eye care accessibility.