Posters

Truly “Discharged to Optom”?: rate of re-presentation of postop cataract patients to the hospital ophthalmic department

Poster Details

First Author: A.O'Regan IRELAND

Co Author(s):    S. Chetty   S. Quinn   P. Mullaney              

Abstract Details

Purpose:

Cataract surgery represents a significant workload for ophthalmologists, with over 12,000 procedures being carried out in Ireland annually. Post-operative shared care with community optometrists can reduce the need for follow-up appointments in hospital, and the 2012 Royal College of Ophthalmologists guidelines support this model of care. Eight years after the introduction of a shared-care pathway for cataract surgery in Sligo University Hospital, we wished to quantify the number of patients who are discharged to the community on the day of surgery, and the proportion that are referred back or re-present to the hospital due to cataract-related issues or complications.

Setting:

Sligo University Hospital Ophthalmic department, Ireland. Our department serves a large and predominantly rural catchment area in the Northwest of Ireland. Our cataract care pathway consists of two pre-operative visits (one doctor-led, one nurse-led), and one post-operative visit at 4 weeks, which takes place in the community with an optometrist.

Methods:

We collected data on all patients who underwent cataract surgery in Sligo University Hospital over the three month period July-September 2019. Electronic patient records were used to establish whether the patient was discharged on the day of surgery and if they re-attended the department post-operatively. Post-operative complications were recorded. Microsoft Excel was used to obtain descriptive statistics.

Results:

394 cataract procedures were carried out over the three months. 370 patients (93.9%) were discharged on the day of surgery to an optometrist for their post-operative care. Of those, 40 (10.8%) were referred back or re-presented to the hospital ophthalmic service. 12 (30%) re-attended prior to their 4-week post-op appointment with the optometrist. 26 of the 40 patients who re-presented had a post-operative complication. Dry eye was the most common presentation (ten patients - 29% of all post-op complications), followed by post-op uveitis (six patients), and cystoid macular oedema (five patients). Severe post-operative complications consisted of two retinal detachments and one retained lens fragment.

Conclusions:

Shared care for uncomplicated post-operative patients is an effective way of reducing the workload associated with cataract surgery. 94% of our patients were deemed suitable for community optometry follow up, and 89% of these did not need to be seen again in the hospital ophthalmic department. Strong communication links and re-referral pathways from community optometry to the Hospital Ophthalmic department is imperative for timely management of post-operative complications.

Financial Disclosure:

None