Abstract
Introduction/Background: The purpose of the eye casualty clinic (ECC) is to manage patients with ocular emergencies, however a large number of patients attended the eye casualty clinic did not have an acute problem and could have been treated by their General Practitioner (GP) or referred to the eye outpatient clinic.
Aim: To identify the number of patients attending the ECC every day and their route of referral
and to estimate the number of patients who could have be seen and managed by a competent ophthalmic nurse practitioner.
Methods: A retrospective analysis was conducted using the notes and history of all patients who
attended the eye casualty clinic at the Princess Margaret Hospital in Swindon during two weeks in
March 2006.
Results: The average daily attendance was 21 patients who were seen between morning and
afternoon sessions in the Eye Casualty Clinic.112 (54%) patients were female. The median patient
age was 50 years with an age range of 1 to 91 years. 68 (34.2%) patients attended as self referrals
without GP letters as our eye casualty clinic is open to the general public from 9.00 a.m. to 5.00
p.m. A & E referred 28 (14.1%) patients of which only 3 had a General Practitioner (GP) letter and
only 1 patient had a walk-in centre letter. There was insufficient information to assess whether 14
patients could have been managed by a nurse; of the remaining 195 visits, 50 (25.6%) patients could
have been managed by an Ophthalmic Nurse Practitioner and 145 (74.4%) patients could not have been managed by an Ophthalmic Nurse Practitioner.
Conclusion: The workload of the eye casualty doctors could be decreased by 38.6% if defined categories of patients were managed by the ophthalmic nurse practitioner, appropriate referrals
were directed to the General Clinic and casualty patients were not followed up inappropriately.