A recent study analyzed the accuracy and quality of 220 patient referrals from primary care to ophthalmology at Virgen Macarena University Hospital in Seville, Spain. The study ultimately aimed to optimize ophthalmologic resources and explore the role of optometrists in improving referral accuracy.

The study found most patients referred to ophthalmology were 60 years old or older, though patients’ ages ranged from 3 to 91 years. The most common reason for consultation was blurred vision or loss of vision (43.63%), and most referrals were determined to be related to age-related conditions like cataracts (27.3%) and refractive errors (20.9%). Anterior segment disease (18.8%), posterior segment disease (14.1%), normal examinations (18.6%), and other conditions (0.9%) were found as well.

Overall, 41.36% of referrals were deemed inappropriate and should have been resolved in primary care. For example, in refractive error referrals the only appropriate referrals were for patients younger than 13 years old, the researchers wrote in their article published in the Journal of Optometry. In those cases just 13% were referred to a different specialized unit while the other 87% were resolved in a single ophthalmology consultation. Between anterior and posterior segment diseases, the researchers suggested that anterior segment conditions should be better prioritized among primary care physicians for care, and posterior segment diseases—such as glaucoma, diabetic retinopathy, and age-related macular degeneration—were more appropriate for referral due to the specialized follow-up visits that are often required for these cases. Cataract cases seemed to be effectively filtered within primary care settings.

“Ophthalmology specialty care is overcrowded due to excessive referrals from primary care,” the researchers wrote. “This may be due to the difficulty of the eye examination, lack of knowledge and measurement equipment….[However,] collaboration with an optometrist could be key in such a mission and unnecessary referrals could be better filtered.”

Patients can be seen more quickly, according to the needs of their condition, when they are appropriately addressed in primary care or by optometrists, the researchers concluded.

A full list of author disclosures is available in the published research.