title: Australian optometric and ophthalmologic referral pathways for people with age-related macular degeneration, diabetic retinopathy and glaucoma.
abstract: BACKGROUND
  This study investigated the referral pathways offered to patients with age-related macular degeneration (AMD), diabetic retinopathy (DR) or glaucoma (GL) by ophthalmologists and optometrists.
  
  
  METHODS
  Australian ophthalmologists and optometrists were surveyed regarding referral decisions to other eye-care specialists (inter- or intra-professional), general medical practitioners (GPs), low vision rehabilitation (LVR) and support services. Thematic analysis and concept mapping were applied to highlight current and ideal referral pathways.
  
  
  RESULTS
  The survey was completed by 155 optometrists and 50 ophthalmologists and deemed representative of their respective professions in Australia. Not surprisingly, the vast majority of the participating optometrists (97 to 99 per cent) referred to ophthalmologists regardless of the underlying condition. Clear differences (Chi-square: p < 0.05) were observed in the referral patterns of optometrists and ophthalmologists to GPs and support services. General medical practitioner services were almost exclusively used for patients with DR, while AMD triggered a significantly higher referral rate to low vision rehabilitation and support services than the other two disorders.
  
  
  CONCLUSIONS
  While ophthalmologists predominantly referred patients with AMD, DR or GL to low vision rehabilitation services, optometrists' referrals were highly skewed toward ophthalmology. Referrals to other supporting services by the two groups were not greatly used. The perceived referral pathways by the two eye-care professionals suggested a unidirectional route, potentially highlighting the need for a more collaborative approach that facilitates optimal use of eye health care and allied services.
authors.affiliation: School of Optometry and Vision Science, University of New South Wales, Kensington, Australia; Department of Ophthalmology, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Khalid F
authors.initials: KF
authors.lastname: Jamous
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jalbert
authors.forename: Michael
authors.initials: M
authors.lastname: Kalloniatis
authors.forename: Mei Ying
authors.initials: MY
authors.lastname: Boon
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002452:Cell Count; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000208:ethnology; D004728:Endothelium, Corneal / Q000473:pathology*; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000175:diagnosis* / Q000208:ethnology; D006801:Humans; D008268:Macular Degeneration / Q000175:diagnosis* / Q000208:ethnology; D008297:Male; D009017:Morbidity / Q000639:trends; D009885:Ophthalmology / Q000379:methods*; D009907:Optometry / Q000379:methods*; D011446:Prospective Studies; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: age-related macular degeneration; diabetic retinopathy; glaucoma; low vision rehabilitation; ophthalmologist; optometrist; referral pathways