June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Analysis of Glaucoma Referral Patterns at a Tertiary Medical Center
Author Affiliations & Notes
  • Kira Szulborski
    Ophthalmology, Beth Israel Lahey Health, Lawrence, Massachusetts, United States
  • Amer Alwreikat
    Ophthalmology, Beth Israel Lahey Health, Lawrence, Massachusetts, United States
    Ophthalmology, Tufts University School of Medicine, Massachusetts, United States
  • Shiyoung Roh
    Ophthalmology, Beth Israel Lahey Health, Lawrence, Massachusetts, United States
    Ophthalmology, Tufts University School of Medicine, Massachusetts, United States
  • David J Ramsey
    Ophthalmology, Beth Israel Lahey Health, Lawrence, Massachusetts, United States
    Ophthalmology, Tufts University School of Medicine, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Kira Szulborski, None; Amer Alwreikat, None; Shiyoung Roh, None; David Ramsey, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3067. doi:
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    • Get Citation

      Kira Szulborski, Amer Alwreikat, Shiyoung Roh, David J Ramsey; Analysis of Glaucoma Referral Patterns at a Tertiary Medical Center. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3067.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The aim of this study is to understand the factors that limit the comprehensive evaluation of patients with primary open angle glaucoma (POAG) referred to a sub-specialist.

Methods : Retrospective, cross-sectional study of 72 internal referrals for POAG from ophthalmology versus optometric providers to the glaucoma service at the Lahey Hospital & Medical Center, a multispecialty academic group practice. The quality of the referral was assessed according to: (1) the completeness of the clinical triad of recorded intraocular pressure (IOP) measurement, visual field (VF), and cup-to-disc ratio (CDR) for each eye, and (2) the availability of all data necessary to calculate the Ocular Hypertension Treatment Study (OHTS) score.

Results : The rate of completeness using both the clinical triad and OHTS score as measures of quality was similar for ophthalmic and optometric referrals. There was a significant increase in the availability of the clinical triad (57% to 65%; p=0.01) and the OHTS score (24% to 35%; p=0.004) from the time of referral to the consult, largely driven by the addition of VF studies. The amount of time between the referral and the initial sub-specialist consult differed between referrals from ophthalmologists and optometrists (46.5±32.3 days versus 67.1±44.2 days, p<0.001).

Conclusions : Many patients referred to a sub-specialist provider in glaucoma lacked key clinical data necessary to confirm the diagnosis and/or evaluate the stage, severity, or progression of the disease. There remains considerable room for improvement in the management of patients referred for evaluation of glaucoma. A majority of clinical data collection should be performed by referring providers ahead of sub-specialty consultation, thereby improving both the efficiency and effectiveness of sub-specialist consultation.

This is a 2020 ARVO Annual Meeting abstract.

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