MANAGEMENT OF OPHTHALMIC DISEASE IN GENERAL-PRACTICE

A study was undertaken to investigate the management of ophthalmic con ditions in general practice in order to identify areas requiring educa tion and training input. Management of patients with eye disease prese nting to 17 Nottingham general practitioners was examined over a 12-mo nth period. Of all patients registered with the participating doctors, 4% presented with eye problems, accounting for 1.5% of all general pr actice consultations. Children under five years of age had the highest consultation rates, female patients having higher consultation rates than male patients in all age groups. Infective conjunctivitis was res ponsible for 41% of consultations about eye problems and allergic conj unctivitis for a further 13%; 70% of consultations resulted in a presc ription. Corticosteroids were prescribed in 3% of consultations for ey e problems; this was considered inappropriate by the study ophthalmolo gist in over a third of these cases. Patients were referred for furthe r management following 16% of consultations. Thirty nine per cent of r efererals to the hospital ophthalmic service were either to an eye cas ualty department or requested an urgent clinic appointment. While most eye problems are managed solely by general practitioners there is cle arly a need for ophthalmic services that can rapidly provide a special ist opinion. However, most eye disease seen in general practice involv es the external eye or anterior segment, and the diagnosis may be conf idently made using basic ophthalmic history taking and examination ski lls with non-specialist equipment. The acquisition of these skills sho uld be emphasized at undergraduate level and built upon in later years in postgraduate training.