A Quality Assurance Audit of an Orthoptic-Led Virtual Neuro-Ophthalmology Clinic.

Abstract

Neuro-ophthalmology is experiencing increasing demand. There is a lack of literature relating to how we deal with the capacity and demand issues, and the use of virtual clinics. Virtual clinics are well-recognised in other subspecialties to help deal with capacity and demand issues, with reports of non-medical-led clinics, and are supported by the National Health Services Long Term Plan and People Plan. We present a quality assurance audit of our orthoptic-led neuro-ophthalmology virtual clinic. The virtual clinic was developed in October 2014 to help deal with capacity and demand issues, however, only since 2019 have orthoptists been trained to virtually review. This paper provides a summary of a quality assurance audit that was completed to determine concurrence between orthoptic and consultant virtual reviews. From January to August 2021, all patients attending the virtual clinic were reviewed by a trained orthoptist and then audited for concordance by a consultant neuro-ophthalmologist; 163 patients were identified. There was 100% agreement between orthoptic reviewers and consultants regarding visual function status and optical coherence tomography interpretation. Of the patients reviewed, 100% of patients were satisfied and 96% of patients would be happy to be seen in the virtual clinic again. Current demands on the neuro-ophthalmology speciality mean that we need to explore new ways of working. Our outcomes demonstrate a high level of agreement between orthoptists and ophthalmologists, and excellent patient satisfaction results. We hope this highlights where orthoptists can play an invaluable role in the care of neuro-ophthalmic patients and help deal with capacity and demand issues.