Macular Service Provision

Miss Clara McAvoy Consultant Ophthalmologist

Wet AMD- rapid decrease in vision and sudden onset

Treatment Burden Photodynamic therapy:

135 patients per million of population. 3 monthly review.

Anti-VEGF:

450 patients per million of the population. monthly review.

Service Demand2009/2010 Number of

Referrals

September 97

October 89

November 83

December 57

January 53

February 90

Total 469

Management

Consultant Ophthalmologist.

Fast track clinic-ophthalmological examination fluorescein angiography OCT

Diagnosis established- discharged/macular degeneration clinic or medical retina clinic/ clinical trial.

Pathway through the Clinic

Coding

Secretary

ECLO

Doctor

Photographer

Optometrist

Nurse

Clerical Staff

Patients

VIRTUAL

CLINIC

Assess

ETDRS

OCT

Colour Photos

Slit lamp

Assess/Treatment

ETDRS

OCT

Slit lamp

reconfirmConsent

INJECTION

Assess/Treatment

ETDRS

OCT

Slit lamp

reconfirmConsent

INJECTION

1st check

Phone consultation

Clinic VisitSOS

Assess/Treatment

ETDRS

OCT

FFA

Slit lamp

IOP

Consent

INJECTION

Admin

Funding

Appointment

Patient Info

Consent

Patient recruitment

ExternalOptom

GP

Emergency

Gen. Clinics

Retina Clinics

FFA clinic

Patient care patwayFghanchi/2010LIViT service: managing capacity

And/ or

Treatment clinics

reconfirmConsent

INJECTION

Follow up Assessmt

clinic

Capacity- Potential Solutions

Treatment of Macular degeneration by non-retinal specialists.

Intravitreal injections by trained technicians/ nurses.

Follow- up clinics in community by optometrists.

Clinical assessments by trained optometrists/ nurses under supervision of retinal specialist.

Other Considerations

Newer treatments

Newer indications

Cost

Audit

Summary

Consultant Lead.

Hospital Optometrists and experienced imaging technicians.

Audit.

Thank you for your attention