MacIsaac Jessica C, Naroo Shehzad A, Rumney Nicholas J
College of Health and Life Sciences, Aston University, Birmingham, UK.
BBR Optometry Ltd, Hereford, UK.
Clin Exp Optom. 2022 May;105(4):428-434. doi: 10.1080/08164622.2021.1937949. Epub 2021 Jul 27.
Optometrists upskilling and participating in enhanced optometric schemes has the potential to improve service accessibility and alleviate pressure on hospital eye services.
There is a growing demand for eye care in the UK with rising hospital attendances thought to be due in part to an ageing population and a shift in behaviour to favour emergency secondary care.
Records of first-time presentations to the eye casualty department at the County Hospital (Wye Valley NHS Trust), Hereford, UK, over a month were analysed retrospectively and sequentially. The proportion of patients from optometrist referrals with conditions potentially requiring pharmacological intervention, that could have been retained within community optometry by an independent prescriber, was assessed. For general practitioner and self-referrals, the reasons for visit were compared to the Minor Eye Conditions Service criteria for inclusion. Patient conditions reviewed at the hospital following their initial presentation were grouped according to those who could have been discharged to a commissioned optometric service.
The records of 421 patients were organised by the source of referral and condition diagnosed by the hospital practitioner. Thirty-three percent of optometrist referrals could have been managed by an independent prescribing optometrist. Ninety-two percent of patients presenting from general practitioner referrals and 83 percent of self-referrals could have been assessed via the local optometric scheme. Sixty-six percent of patients attending hospital for follow-up could have been seen within the community.
The present analysis highlights the value of commissioned local optometric community services to address acute ocular symptoms and the value of an independent prescribing qualification in helping to further alleviate the burden on hospital emergency eye services. The large number of self-referrals suggests that the general public needs to be further educated on services that are available at a community optometry level.
验光师提升技能并参与强化验光计划有可能改善服务可及性，并减轻医院眼科服务的压力。
在英国，随着医院就诊人数的增加，对眼科护理的需求也在不断增长，这部分归因于人口老龄化以及就医行为向急诊二级护理的转变。
对英国赫里福德郡怀伊谷国民保健服务信托基金郡医院眼科急诊部一个月内首次就诊记录进行回顾性和顺序性分析。评估了验光师转诊的患者中，那些可能需要药物干预、本可由独立处方者在社区验光服务中处理的疾病的比例。对于全科医生转诊和自我转诊的患者，将就诊原因与轻度眼部疾病服务纳入标准进行比较。根据那些本可转至委托验光服务机构的患者，对医院初次就诊后复查的患者病情进行分组。
421例患者的记录按转诊来源和医院医生诊断的病情进行整理。33%的验光师转诊患者本可由独立开处方的验光师处理。92%的全科医生转诊患者和83%的自我转诊患者本可通过当地验光计划进行评估。66%到医院复诊的患者本可在社区接受诊治。
本分析突出了委托当地社区验光服务在处理急性眼部症状方面的价值，以及独立处方资格在进一步减轻医院眼科急诊服务负担方面的价值。大量的自我转诊表明，需要对公众进一步开展社区验光服务方面的教育。
