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Ophthalmic Physiol Opt. 2009 Jan;29(1):26-31. doi: 10.1111/j.1475-1313.2008.00600.x.

The quality of optometrists' referral letters for glaucoma.

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1
Department of Optometry and Visual Science, The Henry Wellcome Laboratory for Visual Sciences, City University, Northampton Square, London, UK.

Abstract

PURPOSE:

The purpose of the study was to evaluate the quality of content of optometrist-initiated glaucoma referral letters arriving at the appointment booking centre at Moorfields Eye Hospital (MEH).

METHODS:

The minimum standard of information required for an ophthalmologist to determine the appropriateness and urgency of glaucoma suspect referral was determined, and criteria for three standards of referral letter formulated: 'Ideal', 'Acceptable' and 'Fail'. These standards were applied to a prospective review of all optometrist-derived referrals for glaucoma or suspected glaucoma cases arriving in the MEH booking centre over a 4-month period. The contents of each letter were scrutinised and classified based on the criteria within each standard.

RESULTS:

Forty-nine per cent of referral letters were found to be of 'acceptable' quality, 7%'ideal' quality and the remainder classed as "fail". The main reason for failure was an omission of non-clinical information, including patient and/or referring practice details, although 26% of letters failed to include an optic disc evaluation and 6% failed to provide intra-ocular pressure measurements. Two-thirds of 'acceptable' letters did not reach the 'ideal' standard due to a lack of discussion of risk factors, visual field analysis or recommendations for referral speed.

DISCUSSION:

The information gleaned from this prospective study indicates a need to improve the quality of optometrists' glaucoma referral letters, particularly with respect to completion of all the items set out on the General Ophthalmic Services (GOS) 18 referral form.

[Indexed for MEDLINE]

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