Referral Patterns to an Ophthalmic Outpatient Clinic in a Tertiary Eye Care Center in Iraq

Doi: 10.36351/pjo.v40i3.1742

Abstract

Purpose:  We aim to conduct a comprehensive review of outpatients at a tertiary ophthalmology clinic to evaluate various aspects including the spectrum of eye disorders, referral patterns, reasons for referral, and patient self-assessment, with a particular focus on self-referrals.

Study Design:  A cross-sectional study.

Place and Duration of Study:  Ibn Al-Haitham Teaching Eye Hospital from April to May, 2023.

Methods:  Referral letters were grouped into the primary health center (PHC), secondary hospital, internal referral and private clinic. Referral letter quality was assessed based on clinical information and particular request.

Results:  A total of 1367 individuals aged 40.8 ± 22.17 years were eligible for study. There were 19.2% referrals form PHC, 18.4% from secondary hospitals, 10.7% from private clinics, 3.3% were internal referrals, 37.2% were self-referred and 11.3% had medical or surgical follow-up. Blurred vision was the predominant complaint of 677 (51.6%) patients. Out of 659 referral letters, 25% scored two essential information items, 5.2% scored three, and only 0.8% scored four items. The majority (97.2%) of letters provided specific requests. Among all, 26.3% of PHC, 38.2% of hospitals, 34.9% of private clinics, 21.7% self-referred and 51.1% of internally referred patients considered their situations difficult.

Conclusion:  Majority of cases seen in ophthalmology tertiary centers consist of common conditions that could be effectively managed by PHCs and general hospitals. Improved referral standards for specialized medical institutions may reduce tertiary hospital over population.