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The Accuracy, Quality and Timing of Referrals to the Ophthalmology Division at the University Hospital of the West Indies

Journal Authors: 


Objective: To determine the accuracy, quality and timing of ophthalmic referrals.

Design: This was a prospective study. The data was collected using a pro forma. All patients gave voluntary written consent.

Setting: The Ophthalmology Division at the University Hospital of the West Indies

Participants: All new patients referred to the Ophthalmology Division from August 3, to November 3, 2016. It excluded patients referred for disease screening.

Result: There were 207 patients recruited, 114 (55%) males and 93 (45%) females, aged four months – 87 years (Mean age 45.4years, SD 20.8). The majority were from general practitioners (33%), followed by ophthalmologists (28%) and emergency physicians (23%). The most common conditions were glaucoma (12%), cataract (10%) and uveitis (10%). Only 20% of referrals contained all four referral elements - history, examination, visual acuity and diagnosis. Ophthalmologist referrals were most accurate (89%), while general practitioners (29%) were least accurate. Mean time from referral to the patient presenting to the eye clinic and being seen was 82 days for routine and 4.2 days for emergent/urgent referrals. There were 41 adverse events (19.8%); delays due to physician factors (inappropriately written referrals, inappropriate medications used or lack of disease screening) or patient factors including prolonged time to presentation.

Conclusion: There is a high-rate of poorly written referrals and inaccurate diagnoses. Inadequate communication, poor timing of referrals, inaccurate diagnosis and treatment affect patient outcomes. With standardized referrals, patient morbidity may be reduced.


09 May, 2018
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e-Published: 08 Mar, 2019


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