Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2026
Assessing referral quality in glaucoma care: a retrospective analysis of clinical data in optometrist and ophthalmologist referrals.
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Abu Osba Abdelrahman, Nicolela Marcelo T, Eadie Brennan D
Аннотация
OBJECTIVE: To assess the completeness of glaucoma referral documentation and identify omitted clinical information in referrals to glaucoma specialists.
DESIGN: A retrospective chart review.
PARTICIPANTS: Referrals submitted by optometrists and ophthalmologists to 2 glaucoma specialists between January and December 2024.
METHODS: Optometry and ophthalmology glaucoma referrals were retrospectively reviewed and evaluated for documentation completeness. The total completeness score and proportion of missing elements were compared between referral sources. Multivariable analyses were performed to assess the association between referral completeness and intervention at first visit, as well as wait time.
RESULTS: A total of 522 referrals were analyzed, including 336 from optometrists and 186 from ophthalmologists. Optometry referrals were more complete than ophthalmology referrals (median 9 [IQR: 7-10] vs 5 [IQR: 4-6]; p < .001). Visual field testing and optical coherence tomography were among the most frequently omitted elements in both groups. Ophthalmology referrals more often lacked systemic history and systemic medication documentation, whereas optometry referrals more often omitted ocular history and ocular medications. Intervention at first visit occurred more frequently in ophthalmology referrals than optometry referrals (59.7% vs 33.9%; p < .001), corresponding to 1.68 referrals required to result in 1 intervention compared with 2.95 in optometry.
CONCLUSIONS: Glaucoma referral completeness differs significantly by referral source. Optometry referrals were more complete than ophthalmology referrals; however, both groups demonstrated gaps that may impact clinical assessment. These findings support the need for standardized guidelines to improve referral quality and optimize patient care.
DESIGN: A retrospective chart review.
PARTICIPANTS: Referrals submitted by optometrists and ophthalmologists to 2 glaucoma specialists between January and December 2024.
METHODS: Optometry and ophthalmology glaucoma referrals were retrospectively reviewed and evaluated for documentation completeness. The total completeness score and proportion of missing elements were compared between referral sources. Multivariable analyses were performed to assess the association between referral completeness and intervention at first visit, as well as wait time.
RESULTS: A total of 522 referrals were analyzed, including 336 from optometrists and 186 from ophthalmologists. Optometry referrals were more complete than ophthalmology referrals (median 9 [IQR: 7-10] vs 5 [IQR: 4-6]; p < .001). Visual field testing and optical coherence tomography were among the most frequently omitted elements in both groups. Ophthalmology referrals more often lacked systemic history and systemic medication documentation, whereas optometry referrals more often omitted ocular history and ocular medications. Intervention at first visit occurred more frequently in ophthalmology referrals than optometry referrals (59.7% vs 33.9%; p < .001), corresponding to 1.68 referrals required to result in 1 intervention compared with 2.95 in optometry.
CONCLUSIONS: Glaucoma referral completeness differs significantly by referral source. Optometry referrals were more complete than ophthalmology referrals; however, both groups demonstrated gaps that may impact clinical assessment. These findings support the need for standardized guidelines to improve referral quality and optimize patient care.