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Patterns of ophthalmic referral and emergency presentations to an acute tertiary eye service in New Zealand.
MedLine Citation:
PMID:  21952383     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: To establish demographics, referral patterns and clinical characteristics of patients attending an emergency eye service within a major public tertiary teaching hospital and to identify possible targets to improve delivery of patient care. METHODS: Retrospective study of all patients (N=504) attending an acute eye clinic over a representative 2-week period within Greenlane Clinical Centre, Auckland. RESULTS: Mean age was 42.4 plus or minus 20.6 years with mean visual acuity of 6/10. Referrals came from: general-practitioners (GP) (26.2%), self-referrals (18.6%), hospital medical-officers (7.4%), accident and emergency clinics (6.6%) and optometrists (2.2%). 39.1% of patients were follow-up reviews. Main presenting symptoms were pain, red eye and reduced vision. Average waiting-time was 119 plus or minus 98 min. Major diagnoses were trauma, uveitis and adenoviral keratoconjunctivitis (AKC). Males were more likely to present with ocular trauma, whereas females were more likely to exhibit uveitis, contact-lens related keratitis and AKC. Outcomes included follow-up (48.2%), referral to speciality ophthalmology care (19.0%), referral to other clinics (5.75%), and discharge (33.7%). CONCLUSION: A significant proportion of presentations could have been appropriately referred to outpatient departments or potentially managed by primary healthcare providers. Potential initiatives to manage excessive workload demands might target prevention of ocular trauma, improved contact-lens education, limiting the spread of AKC and improved GP education.
Authors:
Divya Perumal; Rachael Niederer; Sue Raynel; Charles N J McGhee
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Publication Detail:
Type:  -     Date:  2011-8-12
Journal Detail:
Title:  The New Zealand medical journal     Volume:  124     ISSN:  1175-8716     ISO Abbreviation:  -     Publication Date:  2011  
Date Detail:
Created Date:  2011-9-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401067     Medline TA:  N Z Med J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  35-47     Citation Subset:  -    
Affiliation:
Department of Ophthalmology, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand. c.mcghee@auckland.ac.nz.
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