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Collaborative care of non-urgent macular disease: a study of inter-optometric referrals.
- Source :
-
Ophthalmic & Physiological Optics . Nov2016, Vol. 36 Issue 6, p632-642. 11p. 3 Charts, 2 Graphs. - Publication Year :
- 2016
-
Abstract
- Purpose Diseases involving the macula and posterior pole are leading causes of visual impairment and blindness worldwide and may require prompt ophthalmological care. However, access to eye-care and timely patient management may be limited due to inefficient and inappropriate referrals between primary eye-care providers and ophthalmology. Optometrists with a special interest in macular disease may be useful as a community aid to better stratify and recommend best-practice management plans for suitable patients. This study assesses such a notion by appraising the optometric referral patterns of patients with suspected macular disease to an intermediate-tier optometric imaging clinic. Methods We performed a retrospective review of patient records and referrals using patients examined at Centre for Eye Health ( CFEH) for an initial or follow up macular assessment between the 1/7/2013 and 30/6/2014 ( n = 291). The following data were analysed: patient demographic characteristics, primary reason for referral, diagnosed/suspected condition, CFEH diagnosis and recommended management plan. Results The number of referrals stipulating a diagnosis, confirmed after evaluation at CFEH was 121 of 291 (42%). After evaluation at CFEH, the number of cases without a specific diagnosis was approximately halved (reduced from 47% to 23%), while the number of cases with no apparent defect or normal aging changes rose from 1% to 15%. Overall diagnostic congruency for specified macular conditions was high (58-94%); cases were seldom (30/291, 10%) found to have a completely different macular condition. 244 of 291 (84%) patients seen at CFEH were recommended ongoing optometric care: either with the referring optometrist or through recall to CFEH. Referral to an ophthalmologist was recommended in 47 instances (16%). Conclusions More widespread adoption of intermediate-tier optometric eye-care referral pathways in macular disease (following opportunistic primary care screening) has the potential to reduce the number of cases with non-specific diagnoses and to increase those with a diagnosis of normal aging changes or no apparent disease. The majority of cases seen under this intermediate-tier model required ongoing optometric care only and did not require face-to-face consultation with an ophthalmologist. [ABSTRACT FROM AUTHOR]
- Subjects :
- *VISION disorders
*EYE care
*OPTOMETRISTS
*RETINAL degeneration
*PRIMARY care
Subjects
Details
- Language :
- English
- ISSN :
- 02755408
- Volume :
- 36
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Ophthalmic & Physiological Optics
- Publication Type :
- Academic Journal
- Accession number :
- 119102898
- Full Text :
- https://doi.org/10.1111/opo.12322