Cambridgeshire cataract shared care model: community optometrist-delivered postoperative discharge scheme

To evaluate a community optometrist-delivered postoperative discharge scheme in patients who underwent same day discharge from the hospital eye service (HES) following cataract surgery.

A service-level agreement (SLA) was agreed between the HES, primary care trust and community optometrists in Cambridgeshire regarding community follow-up after cataract surgery. Patients undergoing uncomplicated surgery with no significant ocular comorbidity were eligible for same day discharge to community optometrists. Feedback return rate and unintended medical interventions were assessed using an electronic medical record system.

Over a 23-month period, a total of 1492 of 2461 (60.6%) Cambridgeshire patients were discharged to the community on the day of cataract surgery. Complete postoperative feedback was available in 96.85% of these patients. Uneventful postoperative recovery was recorded in 93.77% of patients with 2.95% of patients re-referred. Rates of cystoid macular oedema, uveitis and raised intraocular pressure were 0.6%, 1% and 0.1%, respectively. No patients had sight-threatening complications in this study.

Postcataract surgery follow-up by community optometrists provides the advantages of care closer to home and avoids unnecessary hospital visits for patients undergoing uncomplicated cataract surgery.