Bristol Eye Hospital optometrist Ben Phipps on an enhanced macular referral pathway

Service lead for medical retina optometry at Bristol Eye Hospital, Ben Phipps, has described how a new enhanced macular referral pathway has improved patient care.

Through the pathway, primary care optometrists can send optical coherence tomography scans of the patient they have examined, alongside fundus imagery and relevant clinical information to the hospital eye service.

Speaking with OT at the AOP’s Hospital and Specialty Optometrists Conference, Phipps added that this is accompanied by a summary care record from the patient’s GP.

“We can then review all of that information and make decisions on what is best for the patient,” he said.

Phipps shared that feedback is provided to the primary care optometrist through the Opera system.

“That has been working really, really well,” he said.

He highlighted that before the new enhanced macular referral pathway was introduced, patients referred by optometrists to the hospital eye service for wet age-related macular degeneration (AMD) only had the condition 25–30% of the time.

“What that means is that 70% of the patients don’t have AMD, and those slots are taken up by them – not by the patients who really need them,” Phipps shared.

The hospital optometrist observed that the new pathway is a “much better experience” for patients.

“They will go to their optometrist and have all the scans that are necessary to make a provisional diagnosis. All that information will be sent to the hospital and it will be reviewed the next day,” Phipps said.

He added that sometimes patients who do have wet AMD will be able to have treatment the same week that they were first seen in primary care optometry.

“They have treatment much quicker and this is significantly better than what we were achieving,” he said.

Analysis of data from the new pathway found that there was a median waiting time of eight days between a referral being received and the patient having treatment.

“That is significantly better than the national ophthalmology dataset, which reports that 40.3% of the time people are having injections within 14 days,” he highlighted.