Assessment of Referrals to the Hospital Eye Service by Optometrists and GPs in Bradford and Airedale

Purpose: To investigate the content of referrals to a hospital eye department and describe differences between referring clinician (optometrist or GP) and referral formats.

Methods: A random sample of 433 new referrals to Bradford Royal Infirmary hospital eye service (HES) during 2007 and 2008 were retrospectively analysed.

Results: Three hundred and eleven referrals (72%) were from optometric practice and 122 (28%) from general practice. Optometric referrals were mainly for cataract and posterior capsular opacification (27%), glaucoma or suspect glaucoma (20%) and diabetic retinopathy (10%).

Conclusions: The proportion of referrals to the hospital eye service from optometrists appears to be increasing (1988: 39%, 1999: 48%, present study 72%). GPs mainly refer patients with anterior segment disorders, particularly lid lesions, based on direct observation and symptoms. Optometrists refer patients with a wide range of ocular diseases and include fundus observations and visual acuity measurements in their referrals. There is a need to inform optometrists of what content is required in a referral to the HES from GOS sight tests, at least for the common referral conditions such as age-related cataract and suspect open-angle glaucoma. Referral forms specifically designed for these commonly referred conditions are likely to improve referral quality.