Preoperative evaluations by an internist--are they worthwhile?

The value of preoperative examinations done by internists on ophthalmology patients was assessed. A retrospective chart review of 258 consultations was conducted and information about surgical risk, as defined by strict criteria, was abstracted. A total of 59 surgical risk conditions and 62 incidental problems were detected. In 65% of the risk conditions internists intervened to lessen the patients' risk. Most of these benefits were in patients older than 60 years and very few important problems were detected in those younger than 50. The average cost of the consultation and additional laboratory tests was $146.60. It is concluded that significant benefit was derived at a reasonable cost by patients older than 50 years.