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Nadeem Rob, Lorraine North, Gulrez Ansari, Fani Zacharaki, Manju Chandran, Geeta Menon; Evaluation of the accuracy and efficiency of an optometrist led stable AMD clinic in a regional Age Related Macular Degeneration (AMD) Centre. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3810.
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To assess the accuracy of clinical decision making in an optometrist led AMD clinic.
Constant increase in the number of wet AMD patients has posed a significant strain on the delivery of service in an NHS setting. Failure to provide the recommended four weekly follow-up can result in irreversible loss of vision. To address this problem, we decided that patients who had been stable for at least 6 months should be referred into a special optometrist led stable AMD clinic, run by three trained optometrists. This clinic is a part of the Hospital Eye Service (HES). Retrospective analysis of patients case notes and optical coherence tomography (OCT) images from 4 consecutive clinics was carried out by a senior ophthalmologist. The aim was to assess whether each clinical decision made by the optometrist was considered to be either correct or incorrect. In addition, the average appointment duration incurred by each patient was recorded.
Total of 80 consecutive patient records who were first seen in this clinic were assessed by an independent ophthalmologist. The correct decision was made in 98.5% of cases seen by the optometrists. Only for 1 patient (1.5%) was a different follow-up plan suggested by the ophthalmologist. No adverse event related to this management deviation occurred. The average time for the patients to be seen in the stable clinic pathway from check-in to management was 58 minutes.
It can be concluded that specifically trained optometrists are capable of providing a safe and efficient stable AMD service in the hospital setting. This is an innovative way of reducing the burden on existing AMD services.
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