AB026. Referrals from optometry—a comparative study (the R.O.C.S study)

Background: To characterize emergency optometrist referrals triaged at a tertiary ophthalmology care center by pathology, physical exam findings, and provisional diagnosis accuracy. Methods: Variables extracted from the patients’ charts included date of referral, age, sex, eye(s) under examination, visual acuity (VA) at the time of referral, intraocular pressure (IOP) at the time of the referral, the referring optometrist’s provisional diagnosis, VA at the time of the ophthalmologist consultation, IOP at the time of the ophthalmologist consultation, number of days between referral and ophthalmic consultation, and the ophthalmologist’s diagnosis. Results: After categorizing disease by anatomical location, absolute agreement between optometrist provisional diagnosis and ophthalmologist diagnosis was 60%. A strong correlation was found between optometrist and ophthalmologist VA measurements. IOP measurements were checked less frequently by optometrists. In cases where referral IOP was documented, no significant difference was observed between optometrist and ophthalmologist IOP measures. Conclusions: VA and IOP measurements by optometrists are reliable, but IOP is less frequently checked in the optometry setting. While optometrist referrals correctly localized eye pathology in 60% of cases, posterior pathology was missed in two cases of retinal tear and retinal detachment.