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Evaluation of optometrists’ referrals to ophthalmology for suspected papilloedema

Eye volume 39, pages 1222–1223 (2025)Cite this article

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The number of optometrist referrals with abnormal optic disc appearances suggestive of papilloedema has increased significantly since 2016, leading to an increase in assessments in ophthalmology departments [1] and an increase in neuro-imaging requests [2]. To address this increased workload virtual outpatient clinics (VOCs) have been set up, which have been demonstrated to be effective at screening for papilloedema [3]. In our model of VOC the patients attend for visual function testing, fundal photographs and optical coherence tomography before being telephoned at a later date by a clinician who has reviewed the tests. Decoupling the testing from the consultation reduces the burden on outpatient capacity.

As well as referring patients electively, optometrists can refer to the emergency eye clinic (EEC). We wanted to see if there was a difference in the proportion of patients with true papilloedema between those who the optometrists referred electively and were assessed in the VOC and those who were sent as an emergency to the EEC.

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Data availability

Anonymised data from this study are available on request.

References

  1. McNicholl C, Gill A, Harrison R, Atan D. Impact of the COVID-19 pandemic and Honey Rose case on hospital attendances of patients suspected to have papilloedema. Eye. 2023;37:2157–59.

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  2. Poostchi A, Awad M, Wilde C, Dineen RA, Gruener AM. Spike in neuroimaging requests following the conviction of the optometrist Honey Rose. Eye. 2018;32:489–90.

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  3. Jefferis JM, Griffith N, Blackwell D, Batty R, Hickman SJ, Pepper IM. Is a virtual clinic model a safe and effective way for assessing patients referred with suspiciously blurred optic discs? The blurred disc clinic. Eur J Ophthalmol. 2021;31:3456–62.

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Authors and Affiliations

  1. Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, UK

    V. A. Ramsewak, J. M. Jefferis & I. M. Pepper

  2. Department of Ophthalmology, Chesterfield Royal Hospital, Chesterfield, UK

    V. A. Ramsewak

  3. Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK

    S. J. Hickman

Authors
  1. V. A. Ramsewak
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  2. J. M. Jefferis
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  3. S. J. Hickman
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  4. I. M. Pepper
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Contributions

IMP conceived the study and edited the manuscript. VAR analysed the data and wrote the first draft of the manuscript. JMJ and SJH helped to conceive the study and edited the manuscript.

Corresponding author

Correspondence to S. J. Hickman.

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The authors declare no competing interests.

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Ramsewak, V.A., Jefferis, J.M., Hickman, S.J. et al. Evaluation of optometrists’ referrals to ophthalmology for suspected papilloedema. Eye 39, 1222–1223 (2025). https://doi.org/10.1038/s41433-025-03726-0

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  • DOI: https://doi.org/10.1038/s41433-025-03726-0

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