An extended role for the hospital optometrist

Oster, Jörg; Culham, LE; Daniel, R.

doi:10.1046/j.1475-1313.1999.00427.x

Cited by 15 publications

(12 citation statements)

References 6 publications

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“…Various publications support the potential contribution from nurses, 14 orthoptists, 15 and optometrists. [16][17][18][19] Participation from the optometry profession may occur in either the community setting or within the hospital eye service. To our knowledge, this is the first time that the decision making ability of optometrists working within the hospital glaucoma service has been assessed and compared with that of medical clinicians and published in a peer reviewed journal.…”

Section: Discussionmentioning

confidence: 99%

Agreement between optometrists and ophthalmologists on clinical management decisions for patients with glaucoma

Banes

Culham²,

Bunce

et al. 2006

British Journal of Ophthalmology

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Background/aims: Although optometrists have become an accepted part of the team in many hospital glaucoma clinics, their decision making ability has not been assessed formally. This study aims to document the accuracy and safety of clinical work undertaken by optometrists in the hospital setting by investigating their management decisions on follow up of patients with glaucoma. Methods: Four optometrists and three medical clinicians examined 50 patients each. Clinical findings were recorded as usual in the hospital records but management decisions were documented separately on a specially designed data collection form. Subsequently, the patient records and clinical findings were reviewed retrospectively and independently by two consultant ophthalmologists, who were masked to the management decisions of the optometrists and medical clinicians. The consultants' management decisions were then compared with those made by the optometrists and medical clinicians. Percentage agreements were computed together with kappa (k), or weighted kappa, statistics where appropriate. Results: Agreement between consultants and optometrists was 55% (k = 0.33) for evaluation of visual field status, 79% (k = 0.67) for medical management, 72-98% for other aspects of patient management, and 78% (weighted k = 0.35) for scheduling of next clinic appointment. Very similar levels of agreement were found between consultants and medical clinicians. Conclusion: Agreement between optometrists and consultants, in glaucoma clinical decision making, was at least as good as that between medical clinicians and consultants. Within an appropriate environment, optometrists can safely work as part of the hospital glaucoma team in outpatient clinics.T he number of potential glaucoma sufferers is estimated to increase by about a third over the next 20 years.1 This has raised concerns about the personnel and financial resources required to provide a good standard of clinical care. One means of alleviating the burden on the hospital eye service is to involve non-medical eye care professionals, such as optometrists. Community optometrists already play a key part in the detection of glaucoma in the United Kingdom. They are responsible for more than 95% of glaucoma referrals to the hospital eye service and have the basic skills to detect glaucoma.2 Furthermore, optometrists are becoming increasingly involved in co-managed/shared care schemes and studies have been designed to assess their involvement. [3][4][5][6][7] Studies to date have examined the agreement between ophthalmologists and optometrists regarding individual aspects of the clinical examination-for example, optic disc and intraocular pressure assessment, [8][9][10][11] but, to our knowledge, not that regarding decision making for the management of glaucoma patients.This study was designed to evaluate this agreement between optometrists and two glaucoma subspecialist consultant ophthalmologists. As a benchmark, the same evaluation of agreement was undertaken for medical clinicians (associate special...

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Section: Discussionmentioning

confidence: 99%

Agreement between optometrists and ophthalmologists on clinical management decisions for patients with glaucoma

Banes

Culham²,

Bunce

et al. 2006

British Journal of Ophthalmology

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“…The role of the UK optometrist in both community and hospital practice has undergone significant change, in particular over the past two decades . As the UK population continues to both grow and age, debate about how best to meet increased demand for eye care services is brought to the fore in healthcare workforce discussion, with ophthalmology accounting for the eighth highest level of programme spend in England and for 9% of all National Health Service (NHS) outpatient attendances .…”

Section: Introductionmentioning

confidence: 99%

“…The role of the UK optometrist in both community and hospital practice has undergone significant change, in particular over the past two decades. [1][2][3][4][5][6][7] As the UK population continues to both grow and age, 8 debate about how best to meet increased demand for eye care services is brought to the fore in healthcare workforce discussion, with ophthalmology accounting for the eighth highest level of programme spend in England 9 and for 9% of all National Health Service (NHS) outpatient attendances. 10 Changes in statutory legislation have had a direct impact on the scope of UK community optometric practice in relation to referral rules 11 and amendments to medicines legislation have facilitated access to therapeutic agents.…”

Section: Introductionmentioning

confidence: 99%

Scope of practice of optometrists working in the UK Hospital Eye Service: a national survey

Harper

Creer

Jackson

et al. 2015

Ophthalmic Physiologic Optic

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“…Over the past few years, hospital-based shared care involving optometrists working alongside ophthalmologists to co-manage patients with ocular disease have become well established, and there are a number of shared-care projects which have been developed involving both community and hospital optometrists. [1][2][3][4][5] To the authors' knowledge, there are no published data on hospital optometrists' ability to clinically appraise new referrals from general practitioners or community optometrists to an accident and emergency (A&E) department of an eye hospital. The aim of this study was to evaluate optometrists' ability to correctly identify and manage patients with different ocular conditions seen in the A&E department of an eye hospital.…”

mentioning

confidence: 99%

An evaluation of optometrists' ability to correctly identify and manage patients with ocular disease in the accident and emergency department of an eye hospital

Hau

Ehrlich

Binstead

et al. 2006

British Journal of Ophthalmology

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An extended role for the hospital optometrist

Cited by 15 publications

References 6 publications

Agreement between optometrists and ophthalmologists on clinical management decisions for patients with glaucoma

Agreement between optometrists and ophthalmologists on clinical management decisions for patients with glaucoma

Scope of practice of optometrists working in the UK Hospital Eye Service: a national survey

An evaluation of optometrists' ability to correctly identify and manage patients with ocular disease in the accident and emergency department of an eye hospital

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