Skip to main content
PMC home page
The British Journal of General Practice logoLink to The British Journal of General Practice
. 1994 Dec;44(389):587–589.

Detection and prevention of treatable visual failure in general practice: room for improvement?

A Fink 1, L Wright 1, R Wormald 1
PMCID: PMC1239084  PMID: 7748671

Abstract

An ageing population, the introduction of sight test charges and a problem that has never been adequately addressed since the inception of the National Health Service presents general practitioners with the increasing burden of detecting and preventing visual failure which they feel poorly equipped to deal with. Ophthalmology in general practice is a fundamental requirement for the reduction of avoidable visual failure and this is probably especially true for elderly patients and diabetic patients. A postal survey of general practitioners in Brent and Harrow suggests that there is potential for major improvements in the delivery of eye care by general practitioners, often without much additional expenditure (the equipment is there but it is not used) and with minimal training requirements. Simple changes in already existing screening programmes could potentially have an immediate effect on the visual well-being of the community.

Full text

PDF
587

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Archer D. B. The seed-corn. Trans Ophthalmol Soc U K. 1985;104(Pt 2):211–217. [PubMed] [Google Scholar]
  2. Awh C. C., Cupples H. P., Javitt J. C. Improved detection and referral of patients with diabetic retinopathy by primary care physicians. Effectiveness of education. Arch Intern Med. 1991 Jul;151(7):1405–1408. [PubMed] [Google Scholar]
  3. Brocklehurst J. C., Exton-Smith A. N., Lempert Barber S. M., Hunt L. P., Palmer M. K. Fracture of the femur in old age: A two-centre study of associated clinical factors and the cause of the fall. Age Ageing. 1978 Feb;7(1):2–15. doi: 10.1093/ageing/7.1.7. [DOI] [PubMed] [Google Scholar]
  4. Burns-Cox C. J., Hart J. C. Screening of diabetics for retinopathy by ophthalmic opticians. Br Med J (Clin Res Ed) 1985 Apr 6;290(6474):1052–1054. doi: 10.1136/bmj.290.6474.1052. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cullinan T. R., Silver J. H., Gould E. S., Irvine D. Visual disability and home lighting. Lancet. 1979 Mar 24;1(8117):642–644. doi: 10.1016/s0140-6736(79)91082-1. [DOI] [PubMed] [Google Scholar]
  6. Featherstone P. I., James C., Hall M. S., Williams A. General practitioners' confidence in diagnosing and managing eye conditions: a survey in south Devon. Br J Gen Pract. 1992 Jan;42(354):21–24. [PMC free article] [PubMed] [Google Scholar]
  7. Gilkes M. J. The GP and the specialist: ophthalmology. Br Med J (Clin Res Ed) 1982 Oct 30;285(6350):1247–1248. doi: 10.1136/bmj.285.6350.1247. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Grisso J. A., Kelsey J. L., Strom B. L., Chiu G. Y., Maislin G., O'Brien L. A., Hoffman S., Kaplan F. Risk factors for falls as a cause of hip fracture in women. The Northeast Hip Fracture Study Group. N Engl J Med. 1991 May 9;324(19):1326–1331. doi: 10.1056/NEJM199105093241905. [DOI] [PubMed] [Google Scholar]
  9. Harris A. Health checks for people over 75. BMJ. 1992 Sep 12;305(6854):599–600. doi: 10.1136/bmj.305.6854.599. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Harrison R. J., Wild J. M., Hobley A. J. Referral patterns to an ophthalmic outpatient clinic by general practitioners and ophthalmic opticians and the role of these professionals in screening for ocular disease. BMJ. 1988 Nov 5;297(6657):1162–1167. doi: 10.1136/bmj.297.6657.1162. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hitchings R. A. Visual disability and the elderly. BMJ. 1989 Apr 29;298(6681):1126–1127. doi: 10.1136/bmj.298.6681.1126. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hollows F. C., Graham P. A. Intra-ocular pressure, glaucoma, and glaucoma suspects in a defined population. Br J Ophthalmol. 1966 Oct;50(10):570–586. doi: 10.1136/bjo.50.10.570. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Jones N. P., Lloyd I. C., Kwartz J. General practitioner referrals to an eye hospital: a standard referral form. J R Soc Med. 1990 Dec;83(12):770–772. doi: 10.1177/014107689008301207. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Klein R., Klein B. E., Neider M. W., Hubbard L. D., Meuer S. M., Brothers R. J. Diabetic retinopathy as detected using ophthalmoscopy, a nonmydriatic camera and a standard fundus camera. Ophthalmology. 1985 Apr;92(4):485–491. doi: 10.1016/s0161-6420(85)34003-4. [DOI] [PubMed] [Google Scholar]
  15. Koperski M. How effective is systematic care of diabetic patients? A study in one general practice. Br J Gen Pract. 1992 Dec;42(365):508–511. [PMC free article] [PubMed] [Google Scholar]
  16. Long C. A., Holden R., Mulkerrin E., Sykes D. Opportunistic screening of visual acuity of elderly patients attending outpatient clinics. Age Ageing. 1991 Nov;20(6):392–395. doi: 10.1093/ageing/20.6.392. [DOI] [PubMed] [Google Scholar]
  17. MacCuish A. C. Early detection and screening for diabetic retinopathy. Eye (Lond) 1993;7(Pt 2):254–259. doi: 10.1038/eye.1993.59. [DOI] [PubMed] [Google Scholar]
  18. McDonnell P. J. How do general practitioners manage eye disease in the community? Br J Ophthalmol. 1988 Oct;72(10):733–736. doi: 10.1136/bjo.72.10.733. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Reinstein D. Z., Dorward N. L., Wormald R. P., Graham A., O'Connor I., Charlton R. M., Yeatman M., Dodenhoff R., Touquet R., Challoner T. 'Correctable undetected visual acuity deficit' in patients aged 65 and over attending an accident and emergency department. Br J Ophthalmol. 1993 May;77(5):293–296. doi: 10.1136/bjo.77.5.293. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Sheldrick J. H., Vernon S. A., Wilson A. Study of diagnostic accord between general practitioners and an ophthalmologist. BMJ. 1992 Apr 25;304(6834):1096–1098. doi: 10.1136/bmj.304.6834.1096. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Wilson A. The red eye: a general practice survey. J R Coll Gen Pract. 1987 Feb;37(295):62–64. [PMC free article] [PubMed] [Google Scholar]
  22. Wormald R. P., Wright L. A., Courtney P., Beaumont B., Haines A. P. Visual problems in the elderly population and implications for services. BMJ. 1992 May 9;304(6836):1226–1229. doi: 10.1136/bmj.304.6836.1226. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

RESOURCES