Referrals to the Urgent Eye Clinic (UEC) are rising, leading to an increased demand on services. Many of these referrals are deemed as non-urgent. One method of referral to the UEC is via Accident and Emergency (A&E). In some areas in the country, patients who present to A&E with an acute eye problem will be initially seen by A&E clinicians and be referred to the UEC to be reviewed by ophthalmologists. As a foundation doctor working in ophthalmology, it has been clear that many referrals from A&E have been inappropriate. These have included blepharitis, conjunctivitis and deterioration in vision over the course of a few months being referred to the weekend UEC. I have witnessed all three of these referral examples. Inappropriate referrals from A&E and General Practices lead to increased demand on the UEC.
While serious eye conditions remained prioritised, many patients were too fearful to attend essential clinic appointments. Statistics showed that there was a 79% reduction in ophthalmic appointments in the UK (the highest of any medical specialty) during the pandemic. It is estimated that more than three thousand people have lost vision due to delays in the identification and treatment of eye disease during the pandemic (2). The pandemic crisis will end, sooner or later but the real challenge remains: the episodes of avoidable sight loss that may have occurred due to backlog of services.
PVD is a common condition that all clinicians may encounter throughout their career. It is important to know the relevant symptoms so that we can counsel patients and to appropriately refer to rule out sinister causes.