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Original research
Clinical safety of a minor eye conditions scheme in England delivered by community optometrists
  1. Evgenia Konstantakopoulou1,2,3,
  2. Robert A Harper4,
  3. David F Edgar1,
  4. Genevieve Larkin5,
  5. Sarah Janikoun6,
  6. John G Lawrenson1
  1. 1Division of Optometry and Visual Science, Centre for Applied Vision Research, City University of London, London, UK
  2. 2NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  3. 3University College London, Institute of Ophthalmology, London, UK
  4. 4Manchester Academic Health Science Centre, Manchester Royal Eye Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  5. 5King’s College Hospital NHS Foundation Trust, London, UK
  6. 6Guy’s and St Thomas’ NHS Foundation Trust, London, UK
  1. Correspondence to Dr Evgenia Konstantakopoulou; evgenia.konstantakopoulou{at}moorfields.nhs.uk

Abstract

Objective The aim of this study was to monitor the activity and evaluate the clinical safety of a minor eye conditions scheme (MECS) conducted by accredited community optometrists in Lambeth and Lewisham, London.

Methods and analysis Optometrists underwent an accredited training programme, including attendance at hospital eye services (HES) clinics. Patients who satisfied certain inclusion criteria were referred to accredited MECS optometrists by their general practitioners (GPs) or could self-refer. Data were extracted from clinical records. A sample of MECS clinical records was graded to assess the quality of the MECS optometrists’ clinical management decisions. Referrals to the HES were assessed by the collaborating ophthalmologists and feedback was provided.

Results A total of 2123 patients (mean age 47 years) were seen over 12 months. Two-thirds of the patients (67.3%) were referred by their GP. The most common reasons for patients needing a MECS assessment were ‘red eye’ (36.7% of patients), ‘painful white eye’ (11.1%), ‘flashes and floaters’ (10.2%); 8.7% of patients had a follow-up appointment. Of the patients seen, 75.1% were retained in the community, 5.7% were referred to their GP and 18.9% were referred to the HES. Of the HES referrals, 49.1% were routine, 22.6% urgent and 28.3% emergency. Of the records reviewed, 94.5% were rated as appropriately managed; 89.2% of the HES referrals were considered appropriate.

Conclusion The findings of this study indicate that optometrists are in a good position to work very safely within the remits of the scheme and to assess risk.

  • public health
  • glaucoma
  • cornea
  • conjunctiva

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjophth-2017-000125

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    Footnotes

    • Contributors EK was involved in the design of the study, in the acquisition and analysis of the data and wrote the manuscript. DFE was involved in the design of the study, data analysis, drafting and critical revision of the manuscript. RAH was involved in the design of the study, data analysis, drafting and critical revision of the manuscript. GL and SJ were involved in the design of the study, analysis of the data and critical revision of the manuscript. JGL was involved in the design of the study, data analysis, drafting and critical revision of the manuscript. All authors read and approved the final manuscript.

    • Funding This work was funded by the College of Optometrists as part of the Enhanced Scheme Evaluation Project.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The study was approved by the Research and Ethics committee of the School of Health Sciences, City, University of London, and followed the principles of the Declaration of Helsinki.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Additional unpublished data may be available by contacting the authors.