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Neuro-Ophthalmology Referral Patterns: Learnings From Colombia
Sohum Sheth1, Lina Ramirez-Sanchez, Juliana Vanessa Rincón-Lopez
1College of Medicine (SS), University of Florida, Gainesville, Florida; Escuela de Medicina. Fundación Universitaria Sanitas, Bogotá (LR-S, JVR-L), Colombia; Vision Colombia Research Group (JVR-L), Fundación Universitaria Sanitas, Bogota, Colombia; and Department of Ophthalmology (AJM-V), College of Medicine, University of Florida, Gainesville, Florida.
Patients face long delays and misdiagnoses before seeing a neuro-ophthalmologist. Improving access to neuro-ophthalmology appointments can enhance patient care and reduce healthcare waste.
Area of Science:
- Ophthalmology
- Neurology
- Health Services Research
Background:
- Global neuro-ophthalmologist shortage impacts patient care.
- Supply-demand mismatch leads to extended wait times and diagnostic delays.
- Limited data exists on referral patterns in resource-limited settings.
Purpose of the Study:
- To investigate referral patterns for a neuro-ophthalmology clinic in Bogota, Colombia.
- To analyze patient demographics, wait times, and diagnostic accuracy.
- To identify factors influencing diagnostic outcomes.
Main Methods:
- Retrospective chart review of 535 patients from July 2020 to July 2021.
- Data collection included demographics, time to neuro-ophthalmology appointment (NOA), prior consultations, and diagnostic tests.
- Comparison of diagnoses at referral versus post-NOA.
Main Results:
- Median wait time from symptom onset to NOA was 365 days; referral to NOA was 30 days.
- 63.9% of patients had partial or complete misdiagnosis before NOA.
- Longer time from symptom onset to NOA predicted less accurate initial diagnoses.
Conclusions:
- Significant delays and misdiagnoses are prevalent before neuro-ophthalmology consultations.
- Timely access to neuro-ophthalmology care is crucial for improving patient outcomes.
- Optimizing referral pathways can reduce healthcare resource utilization.
