Dr Rachel Fletcher is a junior doctor in the UK. She completed her medical degree at Peninsula Medical School and is currently completing the Diploma of Tropical Medicine at Liverpool School Tropical Medicine.
Background: Mydriatic drops are commonly used in ophthalmology clinic to aid fundus examination. The risk of mydriatic drops precipitating glaucoma is low.1 However, mydriatic drops can have an impact on patients and their experience of ophthalmic services. Patient centred care should address patients’ expectations.\r\nResearch into patient perceptions of dilating eye drops is limited. Patient’s perceptions of dilating eye drops, side effects and the information patients received in clinic was reviewed. Methods: A printed questionnaire was given to all patients attending clinic (single-centre) for the period of one week (July 2014) and returned by the patients on leaving the department. The questionnaire assessed patient demographics, patient satisfaction, prior information given, clinic information and whether patients had driven to clinic.\r\n
Results:\r\n162 questionnaires were completed. Overall patients were happy with the way they received information about the dilating drops and 98% (n=159) reported they would be happy to have the drops again in the future.\r\n82% (n=13) of patients, had been informed prior to attending clinic that dilating eye drops may be used. But several patients were unsure why the drops were needed (27%, n= 44) and worryingly, 16% (n= 26) of patients admitted to driving immediately after their appointment. \r\nMost patients were informed of the risks associated with mydriatic drops and the majority of patients felt blurred vision was the most troublesome, potential side effect (83%, n=134).\r\n72 % (n=117) of patients were aware pain may occur and when to seek medical advice. Whilst 83 % had been informed of the potential risk of glaucoma following drop instillation.Conclusion:\r\nIn sampling just one department, six different data sources were used to inform patients of the potential side effects of dilating drops. It appeared that a simpler, replicable and more consistent method of consenting patients for mydriatic drops was required to aid informed, patient consent.\r\nThe potential side effects of mydriatic drugs did not deter patients from re-attending clinics. The majority of patients would be happy to receive dilating drops in the future.\r\nIncreased patient education prior to attending clinic is needed to ensure the issue of driving is addressed.\r\n\r\n\r\n\r\n
Premature babies are at risk of sight-threatening, retinopathy of prematurity (ROP). If untreated, severe ROP can result in serious vision impairment. The goal of screening is to identify the more severe stages early enough to allow appropriate intervention. \r\nAim\r\nTo measure adherence on completeness of ROP screening programme and timing of first screening in premature babies admitted on special care baby unit.\r\nMethods\r\n We extracted the bulk of our information from BadgerNet, a platform designed for the recording of all daily events within the unit. 84 babies admitted to the unit during between 01/03/14 to 29/02/16 eligible for ROP screening were identified on BadgerNet. Hospital case notes of babies who were recorded as late for their ROP screening were requested.
\r\nResults\r\n1. % of babies <32 weeks GA or <1501g birthweight who receive at least one ROP eye examination - achieved 100% \r\n2. % of babies < 27 weeks GA receiving a first ROP screening exam by 31 completed weeks postmenstrual age- achieved 91% \r\n3. % of babies 27 –32 weeks receiving a first ROP screening exam before 4 completed weeks postnatal age- standard 95% - achieved 94% \r\n4. % of babies >32 weeks but <1501g birthweight receiving a first ROP screening exam before 5 completed weeks postnatal age - achieved 100%\r\nConclusion\r\nThere is a need for more efficient and effective recording of ROP screening test for eligible babies to achieve improvement in compliance with the guidance. Implementation of a sticker system on cover of patients’ notes to prompt nursing staffs and clinicians to document ROP screening in case notes and to ensure screening is arranged on time. Ophthalmologists to access badger for recording of ROP screening in real time to avoid existing lag between recording and actual screening.\r\n\r\n