Enlisting the eccentric photoscreener in a public hospital eye department.

We analysed retrospectively non-acute new referrals of children to Waikato Hospital over one year. It was found that children were required to wait unacceptably long to be seen. Almost half the children with established amblyopia were not seen until after the age of five years (42% were not referred until after that age). On the other hand, half the children seen had no significant pathology, and the high level of non-attendance also wasted clinic time. An attempt was made to address these problems by holding regular screening clinics using a photoscreener, assessing all children within three weeks of referral so that children with pathology could be examined and treated promptly. Preliminary investigations into mass community photoscreening produced an average recall rate of 11% (54% of whom fell into our definition of pathological). We feel that enlisting the photoscreener has provided a much more efficient paediatric service, which it is hoped will lead to a reduction in visual loss due to amblyopia.