Sunderland Eye Infirmary serves a patient population marked by a higher-than-average incidence and prevalence of wet age-related macular degeneration (AMD). Over the past years, a graduated multidisciplinary approach has been taken to maximise patient management capacity through implementation of AMD triage clinics, nurse-led wet AMD review clinics and optometrist-led OCT clinics for monitoring and assessment. This team-based approach has created added flexibility in the service to ensure efficient and effective delivery of AMD treatment. To extend capacity and flexibility, further SEI has recently introduced independent nurse-led intravitreal anti-VEGF injection lists enabling consultants to focus increasingly on complex pathology, poor responders and other high-risk patients. This article discusses this process to meet the AMD capacity challenge in a busy eye hospital.
The attachment of digital images improved the quality of referral triaging from optometry to secondary eye care in the hospital eye service. It allowed detection of sight threatening disease early and more appropriate allocation of patients to specific specialist clinics at first visit. They allowed safe and speedy 'e-diagnosis' of a subgroup, saving hospital capacity and minimising patient inconvenience. Indirectly the service also reduced the 'did not attend' rate. With recent improvements in camera and internet technology digital images will have an ever increasing role in secondary eye care as it continues to adapt to meet modern demands.
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