Assessment of referrals to the hospital eye service by optometrists and GPs in Bradford and Airedale

Davey, Christopher J.; Green, Clare; Elliott, David B.

doi:10.1111/j.1475-1313.2010.00797.x

Cited by 45 publications

(51 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The first stage of the cataract pathway begins with referral letters sent by medical practitioners and primary eye care practitioners to hospital eye clinics, where ophthalmologists assess a patient's need for cataract surgery. Currently, there is a lack of information on cataract referral content and the few published studies are of overseas healthcare systems with significantly shorter wait times . To our knowledge, there is no information on Australian cataract referrals, and it is unknown how effective referral letters are in providing adequate information to triage referrals ahead of clinic assessment.…”

Section: Introductionmentioning

confidence: 99%

Are cataract surgery referrals to public hospitals in Australia poorly targeted?

Quang

McCluskey

Palagyi

et al. 2017

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

This audit highlights a disconnect between referral letter content and hospital assessment of patients. Current referrals to public hospitals are poorly targeted, with high numbers of referred patients not proceeding to surgery. Patients commonly waited over 1 year to have their ophthalmic assessment at these public hospital eye clinics, revealing lengthy 'wait-for-waits' as a barrier to care. Standardized referral templates may facilitate improvement of referral pathways and shorten waiting times.

show abstract

Section: Introductionmentioning

confidence: 99%

Are cataract surgery referrals to public hospitals in Australia poorly targeted?

Quang

McCluskey

Palagyi

et al. 2017

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

show abstract

“…This progressive optic neuropathy is characterised by damage to the optic nerve head and nerve fibre layer, with visual field (VF) loss which is usually asymptomatic until the disease becomes advanced. Up to 20% of referrals to ophthalmology clinics in the UK are for suspected glaucoma, with the annual cost for monitoring patients with this chronic, and potentially blinding condition estimated to be £22 469 000 2 3…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of schemes that refine referrals between primary and secondary care—the UK experience with glaucoma referrals: the Health Innovation & Education Cluster (HIEC) Glaucoma Pathways Project

et al. 2013

View full text Add to dashboard Cite

ObjectivesA comparison of glaucoma referral refinement schemes (GRRS) in the UK during a time period of considerable change in national policy and guidance.DesignRetrospective multisite review.SettingThe outcomes of clinical examinations by optometrists with a specialist interest in glaucoma (OSIs) were compared with optometrists with no specialist interest in glaucoma (non-OSIs). Data from Huntingdon and Nottingham assessed non-OSI findings, while Manchester and Gloucestershire reviewed OSI findings.Participants1086 patients. 434 patients were from Huntingdon, 179 from Manchester, 204 from Gloucestershire and 269 from Nottingham.ResultsThe first-visit discharge rate (FVDR) for all time periods for OSIs was 14.1% compared with 36.1% from non-OSIs (difference 22%, CI 16.9% to 26.7%; p<0.001). The FVDR increased after the April 2009 National Institute for Health and Clinical Excellence (NICE) glaucoma guidelines compared with pre-NICE, which was particularly evident when pre-NICE was compared with the current practice time period (OSIs 6.2–17.2%, difference 11%, CI −24.7% to 4.3%; p=0.18, non-OSIs 29.2–43.9%, difference 14.7%, CI −27.8% to −0.30%; p=0.03). Elevated intraocular pressure (IOP) was the commonest reason for referral for OSIs and non-OSIs, 28.7% and 36.1%, respectively, of total referrals. The proportion of referrals for elevated IOP increased from 10.9% pre-NICE to 28.0% post-NICE for OSIs, and from 19% to 45.1% for non-OSIs.ConclusionsIn terms of ‘demand management’, OSIs can reduce FVDR of patients reviewed in secondary care; however, in terms of ‘patient safety’ this study also shows that overemphasis on IOP as a criterion for referral is having an adverse effect on both the non-OSIs and indeed the OSIs ability to detect glaucomatous optic nerve features. It is recommended that referral letters from non-OSIs be stratified for risk, directing high-risk patients straight to secondary care, and low-risk patients to OSIs.

show abstract

“…The proportion of referrals from optometrists compared to those from GPs is increasing 17. Currently, there are fewer ophthalmologists in the United Kingdom, pro rata, than in any other European Union nation.…”

Section: Discussionmentioning

confidence: 99%

Teleophthalmology with optical coherence tomography imaging in community optometry. Evaluation of a quality improvement for macular patients

Kelly¹,

Wallwork²,

Haider³

et al. 2011

OPTH

View full text Add to dashboard Cite

PurposeTo describe a quality improvement for referral of National Health Service patients with macular disorders from a community optometry setting in an urban area.MethodsService evaluation of teleophthalmology consultation based on spectral domain optical coherence tomography images acquired by the community optometrist and transmitted to hospital eye services.ResultsFifty patients with suspected macular conditions were managed via telemedicine consultation over 1 year. Responses were provided by hospital eye service-based ophthalmologists to the community optometrist or patient within the next day in 48 cases (96%) and in 34 (68%) patients on the same day. In the consensus opinion of the optometrist and ophthalmologist, 33 (66%) patients required further “face-to-face” medical examination and were triaged on clinical urgency. Seventeen cases (34%) were managed in the community and are a potential cost improvement. Specialty trainees were supervised in telemedicine consultations.ConclusionInnovation and quality improvement were demonstrated in both optometry to ophthalmology referrals and in primary optometric care by use of telemedicine with spectral domain optical coherence tomography images. E-referral of spectral domain optical coherence tomography images assists triage of macular patients and swifter care of urgent cases. Teleophthalmology is also, in the authors’ opinion, a tool to improve interdisciplinary professional working with community optometrists. Implications for progress are discussed.

show abstract

Assessment of referrals to the hospital eye service by optometrists and GPs in Bradford and Airedale

Cited by 45 publications

References 22 publications

Are cataract surgery referrals to public hospitals in Australia poorly targeted?

Are cataract surgery referrals to public hospitals in Australia poorly targeted?

The effectiveness of schemes that refine referrals between primary and secondary care—the UK experience with glaucoma referrals: the Health Innovation & Education Cluster (HIEC) Glaucoma Pathways Project

Teleophthalmology with optical coherence tomography imaging in community optometry. Evaluation of a quality improvement for macular patients

Contact Info

Product

Resources

About