Clinical Study
Eye (2009) 23, 309–313; doi:10.1038/sj.eye.6703075; published online 8 February 2008
Evaluation of a new cataract surgery referral pathway
Proprietary interests/research funding/competing interests: None
J C Park1, A H Ross2, D M Tole2, J M Sparrow2, J Penny2 and M V Mundasad2
- 1West of England Eye Unit, Royal Devon and Exeter Hospital, Exeter, England, UK
- 2Bristol Eye Hospital, Bristol, England, UK
Correspondence: JC Park, West of England Eye Unit, Royal Devon and Exeter Hospital, Barrack Road, Wonford, Exeter, Devon EX2 5DW, UK. Tel: +01 392 406 008; Fax: +01 392 406 022; E-mail: jonparkgfc@hotmail.com
Received 22 August 2007; Accepted 24 November 2007; Published online 8 February 2008.
Abstract
Aims
To compare the quality of referrals and listing rates of direct optometric referrals vstraditional GP referrals for cataract surgery.
Methods
A retrospective cohort of 124 patients referred for cataract surgery was identified (62 via optometric pathway and 62 via GP pathway). The quality of the referral was assessed by establishing if it contained adequate information relating to the College of Optometrists' referral framework document. Age, sex, drug history, listing rate, operative rate, and visual acuity (best corrected) at referral and at the postoperative visit were recorded and compared between the two referral pathways using the Fisher's exact test.
Results
Optometric referrals, relative to GP referrals, were more likely to include information relating to objective visual loss (100 vs87%, P=0.0061) and to counsel the patient (97 vs18%, P=0.0001). GP referrals, relative to optometric referrals, were more likely to comment on personal circumstances (32 vs3%, P=0.0001), past medical history (95 vs68%, P=0.0001), and drug history (94 vs69%, P=0.0009). Operative rates were higher for the optometric direct referrals relative to GP referrals (87 vs69%, P=0.0284). There was no difference in the visual acuity before or after surgery between the pathways.
Conclusions
Optometric direct cataract referrals provide better information on objectively measured vision and better delivery of preoperative counselling. Traditional GP referrals contain better medical history, drug information, and details of personal circumstances. Rates of surgery were slightly higher with optometric referrals.
Keywords:
cataract, referral, optometrists, patient pathway
