Document Detail

A novel, multidisciplinary clinic for complex visual problems in older people.
MedLine Citation:
PMID:  23060021     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Visual symptoms in older people can be complex and inadequately explained by eye pathology alone. Psychological and neurodegenerative processes may manifest as complex visual symptoms, and thus some patients may be poorly served by a purely ophthalmic approach. We have developed a novel multidisciplinary clinic with input from neurology, ophthalmology, and psychiatric specialists. Here, we describe the patient population, disease prevalence, and potential impact of this new clinic.
METHODS: A retrospective audit of paper and electronic records from June 2010 to February 2012 and selected case reports.
RESULTS: Between June 2010 and February 2012 48 patients attended the clinic. Notes were available for 47 (98%). Mean age was 76.2 (range 48-92). The main presenting complaints were hallucinations, followed by nonspecific visual deficit, double vision, blurred vision, and visuospatial deficit. Cognitive impairment was noted in 68% (32/47) of patients, of which 16/32 (50%) were new diagnoses. We were able to give a diagnosis to 98% (46/47) of patients; of these, 74% (35/46) were new diagnoses. A total of 6% (3/47) were felt to have presentations attributable to eye pathology alone, whereas 89% (42/47) were felt to have a neuropsychiatric component. Management included referral to other clinics for continuing care in 43% (20/47) and initiation of therapy in 36% (17/47). The three case reports demonstrate cases, where our multidisciplinary approach aided diagnosis and management of patients with complex visual symptoms.
CONCLUSION: A combined clinic with neurological, ophthalmic, and psychiatric input is an effective way to diagnose and manage complex visual problems in older people.
R C Han; J M Jefferis; J P Taylor; N K Archibald; M P Clarke
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-10-12
Journal Detail:
Title:  Eye (London, England)     Volume:  26     ISSN:  1476-5454     ISO Abbreviation:  Eye (Lond)     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-13     Completed Date:  2013-05-07     Revised Date:  2013-12-04    
Medline Journal Info:
Nlm Unique ID:  8703986     Medline TA:  Eye (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  1536-41     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Cognition Disorders / complications*,  diagnosis,  epidemiology
Eye Diseases / complications*,  diagnosis,  epidemiology
Great Britain / epidemiology
Hallucinations / epidemiology,  etiology*
Middle Aged
Referral and Consultation*
Retrospective Studies

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