Abstract
Purpose We assessed whether patients referred with a diagnosis of cataract require outpatient assessment before listing for surgery or whether the general practitioner could have direct access to the waiting list. We also studied whether pre-assessment clinics made a significant difference to management even when waiting times were long.
Methods Data about patients referred with a diagnosis of cataract to the Oxford Eye Hospital and associated hospitals were collected. Seventy-five patients were prospectively studied and 100 patient records were retrospectively analysed.
Results Twenty-six per cent of patients had a misdiagnosis or additional problems affecting management. Optometrists provided more information than general practitioners, but their diagnostic accuracy was equal (73% optometrists, 75% general practitioners). At the pre-assessment clinic pupil dilatation changed management in only 4% of patients.
Conclusion Listing patients on the basis of referral letters would be inappropriate in 1 in 4 patients. Pre-assessment clinics rarely picked up a clinically relevant change. Thus if outpatient consultation included a decision on the exact surgical plan including implant power, then pre-assessment clinics may not be necessary.
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Prasad, S., Tanner, V., Patel, C. et al. Optimisation of outpatient resource utilisation in cataract management. Eye 12, 403–406 (1998). https://doi.org/10.1038/eye.1998.95
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DOI: https://doi.org/10.1038/eye.1998.95