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Introducing the ‘Benign Eyelid Lesion Pathway’: 1 year experience of synchronous tele-oculoplastics in a tertiary hospital

Abstract

Background

Patients with benign eyelid lesions make up a large proportion of referrals to the oculoplastic service and lend themselves well to telemedicine with assessments heavily reliant on history, observation-based examination and photographs to enable management decision-making. Our tertiary unit set up tele-oculoplastics clinics for all new patients referred for benign eyelid lesions comprising tele-consultation with antecedent patient photograph: Benign Eyelid Lesion Pathway (BELP). One year on, we describe a retrospective analysis of 974 patients looking at distinct parameters of effectiveness.

Methods

We retrospectively collected data from electronic patient records (EPR) for BELP patients from July 2020 to August 2021 (n = 974). We analysed time efficiency (referral time to treatment plan, consultation duration in minutes, average waiting times, number of patients seen per clinician and DNA rate), accessibility, safety (via video surveillance clinic) and theatre utilisation.

Results

57.3% (n = 558) were listed for a surgical procedure direct from tele-consultation with 94.9% (n = 513) of these proceeding to surgery; 22.8% (n = 222) were discharged, 10.7% (n = 104) had further video follow-up and 6.7% (n = 65) required face-to-face follow-up. Our results showed efficient referral-to-treatment times, waiting times, consultation times and non-attendance rate. There was only a 2.57% non-attendance rate. There was no missed diagnosis of a malignancy of a presumed benign lesion.

Conclusion

Tele-oculoplastics provides a streamlined, safe, effective, and logistically convenient way to review benign eyelid lesions. With the increased waiting times for referral to biopsy of eyelid lesions, this clinic shows it is imperative to provide digital accessibility for patient assessment and booking to operating theatre.

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Fig. 1: Benign Eyelid Lesion Pathway (BELP).
Fig. 2: BELP Outcomes of First Attendance (%).

Data availability

The datasets generated and/or analysed during the current study are not publicly available due to patient identifiable data but are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank the clinicians who see patients in the BELP clinic and Caroline Kilduff for creating the illustrations.

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Contributions

Conception: SK, DS, PT, CD, JU, DE Methodology: LA, SK, AG, HT Investigation: LA, SK, AG, HT Formal analysis: LA, AB, AG Initial drafting: LA, AB Revision: LA, AB, SK, HT, AG Final approval: SK, DS, PT, CD, JU, DE.

Corresponding author

Correspondence to Laura Ah-Kye.

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Competing interests

The authors declare no competing interests.

Ethics approval

Permission to perform this study as a clinical audit was granted by Moorfields Eye Hospital NHS Foundation Trust. Ethical approval was not required.

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Ah-Kye, L., Butt, A., Gupta, A. et al. Introducing the ‘Benign Eyelid Lesion Pathway’: 1 year experience of synchronous tele-oculoplastics in a tertiary hospital. Eye (2022). https://doi.org/10.1038/s41433-022-02166-4

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