A descriptive subgroup analysis of within hospital glaucoma referral in a tertiary center in Portugal

Abstract

PurposeGlaucoma is a progressive and irreversible optic neuropathy carrying tremendous burden in healthcare systems. The aim of our study was to characterize the population referred to a glaucoma subspecialty department (GSD) in a university hospital.MethodsWe analyzed retrospectively the within‐hospital referral to the GSD. Electronic medical records and referral letters between Jan and Dec 2014 were screened. Data was screened for ancillary exams, type of tonometry, number of IOP‐lowering medications and extent of the disease (HODAPP classification). Statistics were performed with STATA v13.0.ResultsA total of 151 patients (78 males) were referred. Mean age was 68.2 (range 18–91). Thirty‐six patients (23.8%) were referred with visual field, pachimetry and OCT. Of those with a visual field, 38 (55.1%) had a mean defect >6 db (of which 17 had >12 dB), with 34 patients having at least two exams. In contrast, 16 (10.6%) were referred with no ancillary exam performed and 67 (50%) had all IOP measurements performed with pneumotonometry. Sixteen patients (10.6%) had a description of a gonioscopy. All patients were under IOP‐lowering treatment, of which 83 (55%) were under 2 or more IOP‐lowering medications. The number of patients referred with more than 80 years old was 29 (19.2%), 5 (18.52)% of which had a complete documentation of the disease. In this subset of patients, 6 (42.8%) had an advanced form of the disease.ConclusionsBetter understanding of our population characteristics will lead to a more accurate referral system. In a significant part of GDS referrals there was insufficient or poor quality clinical data. Our study raises awareness on the importance of an efficient within hospital subspecialist referral, leading to economic and health gain in Ophthalmology departments.