Ee Lin Ong1, Colleen Wilkinson1, Belinda Vayro1, James Walker2,1

Purpose: Delays in patient care are a catalyst for change in every health system. We aim to describe the implementation of an orthoptist-led clinic within a general Ophthalmology service, and evalu- ate its effectivity in improving access to clinical ser- vices for paediatric patients referred to the SCHHS Ophthalmology clinic.
Methods: All paediatric Ophthalmology referrals were triaged by a senior orthoptist. Children referred for strabismus, amblyopia and other condi- tions deemed suitable at the ophthalmologist’s dis- cretion were directed for initial consultation in orthoptic clinic, which ran twice weekly. For each patient, a comprehensive eye assessment was per- formed, including cycloplegic retinoscopy and fun- dus photography. Patient charts were subsequently reviewed with a consultant ophthalmologist to decide on an appropriate management plan. A 12-month retrospective analysis was performed on consecutive patients who were seen in the orthoptist-led clinic between Jan–Dec 2017. Health service evaluation metrics such as patient through- put, new-to-review ratios, and waitlist data were analysed.
Results: A total of 194 referrals were received for patients under 16 years of age in 2017, of which 155 (79.8%) attended the orthoptic clinic. New-to- review ratio improvement was noted in both oph- thalmic and orthoptic clinics. The introduction of the orthoptist-led clinic also decreased the waiting time from referral to initial appointment by 125 days, resulting in a 29.6% reduction in patients exceeding the long wait status.
Conclusion: Orthoptists play a key role as first- contact practitioners in the general ophthalmic set- ting, and are able to provide safe and effective care to children referred for vision-related and ocular- motility issues.