Assessment of glaucoma referral letter for quality and accuracy among patients referred to a tertiary eye care center

Indian J Ophthalmol. 2020 Mar;68(3):471-474. doi: 10.4103/ijo.IJO_914_19.

Abstract

Purpose: To assess the quality and accuracy of glaucoma referrals from ophthalmologist.

Methods: Retrospective review of patients chart with referral letter to a tertiary glaucoma center between January and December 2017. Patients aged <16 years, lens-induced glaucoma, uveitic glaucoma, and glaucoma following retinal and corneal surgery were excluded.

Results: A total of 184 patients referred by 55 ophthalmologists were included. Mean patient age (SD) was 57.8 ± 14 years. Intraocular pressure was not documented in the referral letter in 113 (61%) patients, gonioscopy in 174 (95%) patients, disc findings in 149 (81%) patients, and visual fields in 175 (95%) patients. Thirteen (37%) of the 35 patients referred as open angle glaucoma were found to have angle closure glaucoma. Pseudoexfoliation glaucoma was diagnosed in 29 (16%) patients, of which 18 were missed by the referring ophthalmologist.

Conclusion: In our study >90% of referral letter did not have the essential parameters. A standard template for glaucoma referral is suggested, which will help the patient to get better transfer of care.

Keywords: Angle closure glaucoma; glaucoma; gonioscopy; referral letter.

MeSH terms

  • Female
  • Follow-Up Studies
  • Glaucoma / diagnosis*
  • Glaucoma / physiopathology
  • Gonioscopy / methods*
  • Humans
  • Intraocular Pressure / physiology*
  • Male
  • Middle Aged
  • Quality Indicators, Health Care*
  • Referral and Consultation*
  • Retrospective Studies
  • Tertiary Care Centers*
  • Tomography, Optical Coherence / methods
  • Tonometry, Ocular / methods
  • Visual Fields / physiology*