Abstract
Introduction
Since 2007, the ocular 4:1 multiplex PCR assay in NHS Greater Glasgow and Clyde includes Chlamydia trachomatis (ocular chlamydia (OC)) testing. OC can be identified following routine ‘viral’ ophthalmic testing, including in asymptomatic patients. A published audit from 2008 identified only 25% of our OC patients attended and completed sexual health management, particularly when ophthalmologists initiated treatment. We subsequently created a shared care network between ophthalmology, virology and sexual health (including a designated sexual health advisor) to address these clinical issues.
Methods
A 10-year retrospective service review audit from January 2010 to December 2019 was performed to evaluate this approach.
Results
A total of 86 patients were identified (49 males (57%), median age 23 years (range 16–77)). Ophthalmologists initiated treatment for 37 patients (43%) prior to onward sexual health referral. Of this group, 5 (13.5%) received sub-optimal treatments, and 15 (40.5%) subsequently failed to attend sexual health services for partner notification. Of the 49 (57%) patients who attended sexual health, 25 (51%) had genital chlamydia co-infection, and 98% received adequate systemic treatment. All were offered full sexual health screening and 46 (93.9%) completed partner notification.
Conclusions
This shared care approach more than doubled the proportion of OC patients attending sexual health services over this 10-year period (previously 25%, now 57%). Ophthalmologists could defer treatment to sexual health for more effective OC management; however, challenges remain to address real-world issues of non-attendance, inadequate treatment and incomplete contact tracing. We recommend a multi-disciplinary approach to best manage OC cases identified following ophthalmic testing.
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Acknowledgements
A version of this paper was an oral presentation at the Scottish Ophthalmological Club meeting, September 2019, in Stirling, Scotland.
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Shah, M., Gishkori, S., Edington, M. et al. Ten-year review of a shared care approach in the management of ocular chlamydia trachomatis infections. Eye 35, 1614–1619 (2021). https://doi.org/10.1038/s41433-020-01128-y
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DOI: https://doi.org/10.1038/s41433-020-01128-y
