<p>A Quality Assurance Audit&nbsp;of an Orthoptic-Led Virtual&nbsp;Neuro-Ophthalmology Clinic</p>

Abstract

Introduction: Neuro-ophthalmology is experiencing increasing demand. There is a lack of literature relating to how we deal with the capacity and demand issues, and the use of virtual clinics. Virtual clinics are well-recognised in other subspecialties to help deal with capacity and demand issues, with reports of non-medical-led clinics, and are supported by the National Health Services Long Term Plan and People Plan. We present a quality assurance audit of our orthoptic-led neuro-ophthalmology virtual clinic. Methods: The virtual clinic was developed in October 2014 to help deal with capacity and demand issues, however, only since 2019 have orthoptists been trained to virtually review. This paper provides a summary of a quality assurance audit that was completed to determine concurrence between orthoptic and consultant virtual reviews. Results: From January to August 2021, all patients attending the virtual clinic were reviewed by a trained orthoptist and then audited for concordance by a consultant neuro-ophthalmologist; 163 patients were identified. There was 100% agreement between orthoptic reviewers and consultants regarding visual function status and optical coherence tomography interpretation. Of the patients reviewed, 100% of patients were satisfied and 96% of patients would be happy to be seen in the virtual clinic again. Conclusions: Current demands on the neuro-ophthalmology speciality mean that we need to explore new ways of working. Our outcomes demonstrate a high level of agreement between orthoptists and ophthalmologists, and excellent patient satisfaction results. We hope this highlights where orthoptists can play an invaluable role in the care of neuro-ophthalmic patients and help deal with capacity and demand issues.

Perceptions of vision care following neurological impairment: a qualitative study

“…Survey responses collected by orthoptists during the pandemic raised concerns around ethical and confidentiality issues, in addition to technological issues experienced when delivering this service [39]. However, conflicting survey evidence indicates that telemedicine can be a suitable service for vision care; namely for reporting on the results of previous assessments and ongoing monitoring [40,41]. The authors noted, however, that participants reported issues with the description of clinical findings via telemedicine [41], although no further explanation was offered for this finding due to the nature of the survey data collection method, which lacked in-depth exploration to better understand the patient experiences.…”

“…However, conflicting survey evidence indicates that telemedicine can be a suitable service for vision care; namely for reporting on the results of previous assessments and ongoing monitoring [40,41]. The authors noted, however, that participants reported issues with the description of clinical findings via telemedicine [41], although no further explanation was offered for this finding due to the nature of the survey data collection method, which lacked in-depth exploration to better understand the patient experiences. Comparably, however, our participants also described challenges in understanding information provided by the healthcare providers, often as a result of their other neurological symptoms.…”