Ophthalmology inpatient consultations: an Irish tertiary hospital experience.

ABSTRACT

BACKGROUND: Ophthalmology consultation on inpatients is often important to optimise eye care and provide information for referring teams. Inpatient consultation may constitute a not-insignificant workload however. This study reports on the nature and necessity of ophthalmology inpatient consults in a large Irish hospital. METHODS: Retrospective analysis of all consecutive ophthalmology inpatient consultations over a 12-month period. RESULTS: In total, 359 consult requests were received primarily from adult medicine (57.9%), surgery (22%) and paediatric teams (18.4%). The most common reasons for referral were loss of vision (23.7%); visual field testing (15%); diplopia or abnormal eye movements (11.4%); and screening for ocular features of systemic disease (10.6%). Presumptive diagnoses by referring teams were correct in 29.5% of cases. The majority had normal eye examinations (53.2%) or non-sight-threatening features (16.8%), while a minority had acute eye pathology (30%). Most patients (80.4%) required no intervention. A minority required medical (12.5%), orthoptic (4.6%) or surgical (2.4%) intervention. The majority of patients (81%) were fit for transfer to the eye clinic and did not require bedside examination. CONCLUSIONS: Our study found a high proportion of ophthalmology inpatient consultations had normal eye exams and required no intervention. The quality of referrals was variable suggesting that clearer guidelines and more ophthalmology education is needed for referring teams.