Abstract
Abstract: :
Purpose: To investigate the current opinions of retinal specialists regarding the urgency of examination of a patient with a specific diagnosis after referral by a general ophthalmologist. Methods: Surveys were mailed to 200 retinal specialists who were members of the Vitreous, Retina, or Macula Society. Approximately equal numbers were mailed to each state. Respondents were asked to indicate the recommended and maximal times of referral for eight different diagnoses: endophthalmitis, vitreous hemorrhage, traumatic hyphema, macula-off retinal detachment, peripheral retinal detachment, ruptured globe with anterior involvement, ruptured globe with posterior involvement, and intraocular foreign body. The time categories included the following: within 2 hours, 2-12 hours, 12-24 hours, 24-72 hours, and 72 hours or more. Additionally, the number of years in practice and the state where each respondent practiced was ascertained. Results: The highest amount of agreement among the respondents concerned the diagnosis of endophthalmitis. A large majority (83.5%) indicated they should see a patient within 2 hours of diagnosis by a general ophthalmologist, and 55.7% indicated that between 2-12 hours was the maximum time they would choose to see the patient. For each diagnosis, except for peripheral detachment, the most frequently chosen answer for the recommended time category was different than the most frequently chosen answer for the maximum time category. There was no difference in the answers observed based on region of the country. However, several trends were observed based upon the respondents’ years in practice. Those in practice longer chose shorter recommended referral times for patients with a macula-off retinal detachment. Additionally, they chose shorter maximum referral times for patients with a vitreous hemorrhage as well as those with a macula-off retinal detachment. In contrast, those in practice for a shorter duration chose both shorter recommended and maximum referral times for a peripheral retinal detachment. Most respondents reported practicing from 10-19 years (40.8%), and most respondents were from the Southern states (35.1%). Conclusion: The distribution of data provides a basis of comparison regarding the urgency of examination by a retinal specialist after diagnosis by a general ophthalmologist.
Keywords: 351 clinical (human) or epidemiologic studies: health care delivery/economics/manpower • 554 retina