Sir,

The rising importance of impact factors seems to correspond with reduced case report publication in the ophthalmic literature, reflected by journals changing their ‘Instructions to authors’.1 The impact on the doctor–patient relationship of the publication process has not been considered in the ophthalmic literature. We wished to evaluate ophthalmic journals’ author instructions to compare their approach regarding patient consent for publication.

Case report

We identified 10 journals with which we had previous personal experience of article submission. These were Ophthalmology, Survey of Ophthalmology, Archives of Ophthalmology, British Journal of Ophthalmology, American Journal of Ophthalmology, Journal of Cataract and Refractive Surgery, Eye, and Cornea, British Medical Journal, and Lancet. All 10 journals state that written informed consent for the publication of clinical details and photographs must be obtained.2, 3 Some specify that reviewing or processing cannot proceed until written consent is submitted. All state that publication will not occur without written consent. In all, 50% have their own journal-specific consent form. Such forms would need to be posted to patients for their own reading and signing, unlike the hospital forms, which are explained to the patient at the time of consent. For comparison, our own hospital consent form for photography has three sections and specifically requires consent for taking and storage of images, image use in teaching, and image use for publication.

Comment

This current system means patients can end up being repeatedly contacted for their written permission every time an article is resubmitted to another journal. This is unnecessary and such harassment can damage the doctor–patient relationship. We have experienced withdrawal of consent on one occasion directly due to this. We echo calls for the journal editors to have a standard universal consent form.4, 5 If this is unrealistic, accepting the form that the patient signed happily with informed consent when their images were first recorded would enable processing or review of the paper, and the journal-specific form could be signed on acceptance for publication. This would ensure the patient would only need to be re-contacted once, thus preventing any unfair and unnecessary harassment of patients for written consent.