Review article: Resources for the management of ocular emergencies in Australia

Authors


  • Patricia M O'Connor, PhD, Research Fellow; Carmel T Crock, MB BS, FACEM, Emergency Physician; Rana S Dhillon, MB BS, Neurosurgery Registrar; Jill E Keeffe, OAM, PhD, Principal Research Fellow (Professor) and Unit Head.

Dr Patricia M O'Connor, Population Health Unit, Centre for Eye Research Australia, University of Melbourne, WHO Collaborating Centre for the Prevention of Blindness, 32 Gisborne Street, East Melbourne, Vic. 3002, Australia. Email: ocp@unimelb.edu.au

Abstract

The aim of the present paper is to assess the practical utility of the most common print resources used by practitioners in the management of ocular emergencies. Ten print resources were identified for review (three specialty eye texts, six general emergency medicine texts and one general practice text). The main outcome measures used were the extent a text matched crucial skills criteria in clinical assessment and treatment, and usability. No single print resource addressed all criteria. Red flag systems for clinical assessment and ease of navigation were the best match areas. Only one text inadequately stressed red flag conditions and one text was not ranked as easy to navigate. All texts made assumptions regarding the knowledge/skill level of practitioners, particularly in relation to eye examination procedures and treatment. Photographs ranged in number from 8 to 1500; 3/10 texts provided no photographs. Five texts included detailed instructions on the indications and urgency of referral and follow up for all conditions covered. The remainder lacked details. Only one text used the Australasian Triage Scale. Three texts included photographs/diagrams and instructions for the slit lamp and ophthalmoscope. None covered all procedures specified in the criteria. Only two reflected drug current practice in Australia and provided adequate details on usage. A single comprehensive reference (print and/or web-based) for dealing with ocular emergencies in Australia is clearly needed. Additionally, training and confidence levels of eye care providers must be addressed so that the risk of misdiagnosis and mismanagement of eye emergencies is reduced.

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