Introduction Hospitals in England are reimbursed via national tariffs set out by NHS England. The tariffs payable to hospitals are determined by the activity coded for each patient's hospital visit. There are no national standards or publications within oculoplastics for coding accuracy. Our audit aimed to determine the accuracy of coding oculoplastic procedures carried out in theatres and to assess the financial implications of any discrepancies. Methods We carried out a prospective audit of consecutive oculoplastic procedures performed at one hospital site over a 6-week period. We subsequently created a coding proforma and performed a re-audit using the same methods. Results In the first cycle, clinical coding was 'correct' in 30.7% of cases, 'incomplete' for 12.9% and 'incorrect' for 56.5%. Of the 'incorrect' codes, 54.3% were coded as non-oculoplastic procedures (e.g. extraocular muscle surgery). We discussed our findings with the coding team in order to address the sources of error. We also created a 'tick box' coding proforma, for completion by surgeons. Our re-audit results showed an improvement of 'correct' coding to 85.7%. Conclusion Clinical coding is complex and vulnerable to inaccuracy. Our audit showed a high rate of coding error, which improved following collaboration with our coding team to address the sources of error and by creating a coding proforma to improve accuracy. Accurate clinical coding has financial implications for hospital trusts and consequently Clinical Commissioning Groups. In times of severe financial pressures, this could be a valuable tool, if rolled out over all specialities, to make much needed savings.

Oculoplastic services at a UK district general hospital underwent reconfiguration to incorporate teleconsultations during the COVID-19 pandemic, and patient satisfaction was assessed. Methods All oculoplastic patients at MaidstoneHospital underwent telephone or video consultations in place of face-to-face reviews. Patient feedback surveys were conducted. Results 80 telephone and 40 video consultation responses were analysed. The majority of teleconsultations lasted 6-10 minutes. 55% of telephone and 82.5% of video consultation patients felt face-to-face reviews would not have changed the appointment outcome. Satisfaction scores of 10/10 were given by 71.3% of telephone and 72.5% of video consultation patients. Correlation between age and preference of consultation type was observed, with 62.5% of patients aged >65 years requesting regular faceto-face reviews compared to only 18.8% of 25-64-year-olds. ConclusionPatients highly support teleconsultation adaptations. This is an opportunity to incorporate and enhance teleconsultation facilities to meet current and future demand, especially with ongoing social distancing guidelines.

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A 73-year-old man, with no medical history of note, presented with a 4-week history of an isolated left-sided ptosis and associated periorbital and retro-orbital discomfort. His pupils were spared, his eye movements were not restricted and he was not proptosed. A prompt CT orbits and head scan revealed a large left frontal sinus mucocoele that had eroded into the left orbit. The patient had successful endoscopic sinus surgery under the ear, nose and throat team and 1 month later was seen in ophthalmology clinic. His ptosis and discomfort had fully resolved and he had no neurological sequelae from the surgery.