title: The quality of optometrists' referral letters for glaucoma.
abstract: OBJECTIVE
  The purpose of the study was to evaluate the quality of content of optometrist-initiated glaucoma referral letters arriving at the appointment booking centre at Moorfields Eye Hospital (MEH).
  
  
  METHODS
  The minimum standard of information required for an ophthalmologist to determine the appropriateness and urgency of glaucoma suspect referral was determined, and criteria for three standards of referral letter formulated: 'Ideal', 'Acceptable' and 'Fail'. These standards were applied to a prospective review of all optometrist-derived referrals for glaucoma or suspected glaucoma cases arriving in the MEH booking centre over a 4-month period. The contents of each letter were scrutinised and classified based on the criteria within each standard.
  
  
  RESULTS
  Forty-nine per cent of referral letters were found to be of 'acceptable' quality, 7%'ideal' quality and the remainder classed as "fail". The main reason for failure was an omission of non-clinical information, including patient and/or referring practice details, although 26% of letters failed to include an optic disc evaluation and 6% failed to provide intra-ocular pressure measurements. Two-thirds of 'acceptable' letters did not reach the 'ideal' standard due to a lack of discussion of risk factors, visual field analysis or recommendations for referral speed.
  
  
  CONCLUSIONS
  The information gleaned from this prospective study indicates a need to improve the quality of optometrists' glaucoma referral letters, particularly with respect to completion of all the items set out on the General Ophthalmic Services (GOS) 18 referral form.
authors.affiliation: Department of Optometry and Visual Science, The Henry Wellcome Laboratory for Visual Sciences, City University, Northampton Square, London, UK.
authors.forename: Natalie D
authors.initials: ND
authors.lastname: Scully
authors.forename: Ling
authors.initials: L
authors.lastname: Chu
authors.forename: Dilani
authors.initials: D
authors.lastname: Siriwardena
authors.forename: Richard
authors.initials: R
authors.lastname: Wormald
authors.forename: Aachal
authors.initials: A
authors.lastname: Kotecha
mesh_terms: D015709:Correspondence as Topic; D005194:Family Practice; D005901:Glaucoma; D006801:Humans; D007400:Interprofessional Relations; D008499:Medical Records / Q000592:standards; D009885:Ophthalmology; D009907:Optometry / Q000592:standards*; D011446:Prospective Studies; D012015:Reference Standards; D012017:Referral and Consultation / Q000592:standards*; D013222:State Medicine / Q000458:organization & administration; D013997:Time Factors; D006113:United Kingdom