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New emergency eye care centres help reduce the need to attend hospital

By David Porter

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New measures have been introduced to help patients with emergency eye problems, reducing the need for them to attend hospital during the coronavirus pandemic.

Backed by up to £3 million of Scottish Government funding, Emergency Eyecare Treatment Centres have been established in all health board areas.

New technology is also being trialled by NHS Grampian and NHS Forth Valley.

After a telephone consultation, some patients may be referred to optometrists within the treatment centres who can manage a wide range of conditions without further involvement from GPs or hospitals.

In Grampian and Forth Valley, live video and audio feeds between the centres and consultants in hospitals are also being used to enable more patients to be immediately diagnosed and treated.

The teleophthalmology system was developed in collaboration by the University of Strathclyde, NHS Grampian and NHS Forth Valley connects specialists using a telemedicine platform used by NHS Scotland.

Dr Mario Giardini from Strathclyde University and project lead Dr Iain-Livingston who have helped to develop remote optical assesment.
Dr Mario Giardini from Strathclyde University and project lead Dr Iain-Livingston who have helped to develop remote optical assesment.

Dr Mario Giardini from the University of Strathclyde’s Department of Biomedical Engineering, who developed the system in collaboration with NHS consultant and Strathclyde honorary lecturer Dr Iain Livingstone, said: “The system has allowed a new way of working.

"The technology uses a slit lamp microscope, which emits an intense beam of light to examine the eye, along with a tablet computer transmitting a live video feed.

"This enables a consultant to view the magnified eye remotely. It also uses adapters based on Strathclyde technology to see the back of the eye."

Teleophthalmology is a branch of telemedicine that delivers eye care through digital medical equipment and allows clinicians to provide quality healthcare outside of clinics, providing consultant opinions in community optician practices.

Health Secretary Jeane Freeman said: “While services have changed dramatically over the last few weeks, my message is clear, if you are worried about your health in any way, please get in touch with your GP.

"The same applies to your vision – if you have experienced any problems with your sight, please contact your local high street optician as soon as possible.

“I would like to thank NHS Boards and the optometry and ophthalmology professions for their excellent collaboration in establishing, at pace, more than 50 Emergency Eyecare Treatment Centres across Scotland to manage patients without COVID-19 symptoms who need an emergency face-to-face consultation.

“I am pleased to see some NHS Boards are also using innovative new tele-ophthalmology technology.

"This means that more patients can be immediately diagnosed and treated in a community setting while gaining an expert opinion from the secondary care ophthalmology team.”

Patients without COVID-19 symptoms will be referred for an emergency face-to-face consultation after having a telephone triage or consultation with a community optometrist.

Only the Emergency Eyecare Treatment Centres will examine patients face-to-face.

These premises have been provided with the Personal Protective Equipment (PPE) required to keep patients and practitioners safe.

The centres have been established by each Board with guidance and support from Eyecare Scotland, the national clinical leads multi-professional group.

Routine eye care services were suspended on March 23 and since then, community optometry practices have continued to provide emergency and essential eye care services to patients, enabled by a package of financial support measures from the Scottish Government.

This includes provision of monthly average practice income from NHS services and up to £3 million of funding for the provision of emergency and essential eye care services.

Clinical Lead at NHS Grampian Eye Health Network, John Olson said: “During the Covid-19 pandemic a new way of working is required that will involve joined-up working between primary and secondary care colleagues. The emphasis needs to be on preventing patients from needing a face-to-face consultation if at all possible

“Emergency Eyecare Treatment Centres have already been activated in NHS Grampian and NHS Forth Valley.

“These units are staffed by optometrists, provided with teleophthalmology tools, such as a digital relay comprising of a video link of microscopic view of the eye to be cascaded to an eye doctor at another location, enabling live decision support at the moment it is needed, expanding the range of treatments previously possible in primary care.”

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