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Br J Gen Pract. 1994 December; 44(389): 587–589.
PMCID: PMC1239084

Detection and prevention of treatable visual failure in general practice: room for improvement?


An ageing population, the introduction of sight test charges and a problem that has never been adequately addressed since the inception of the National Health Service presents general practitioners with the increasing burden of detecting and preventing visual failure which they feel poorly equipped to deal with. Ophthalmology in general practice is a fundamental requirement for the reduction of avoidable visual failure and this is probably especially true for elderly patients and diabetic patients. A postal survey of general practitioners in Brent and Harrow suggests that there is potential for major improvements in the delivery of eye care by general practitioners, often without much additional expenditure (the equipment is there but it is not used) and with minimal training requirements. Simple changes in already existing screening programmes could potentially have an immediate effect on the visual well-being of the community.

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Selected References

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  • Archer DB. The seed-corn. Trans Ophthalmol Soc U K. 1985;104(Pt 2):211–217. [PubMed]
  • Featherstone PI, James C, Hall MS, Williams A. General practitioners' confidence in diagnosing and managing eye conditions: a survey in south Devon. Br J Gen Pract. 1992 Jan;42(354):21–24. [PMC free article] [PubMed]
  • Gilkes MJ. The GP and the specialist: ophthalmology. Br Med J (Clin Res Ed) 1982 Oct 30;285(6350):1247–1248. [PMC free article] [PubMed]
  • Hitchings RA. Visual disability and the elderly. BMJ. 1989 Apr 29;298(6681):1126–1127. [PMC free article] [PubMed]
  • Long CA, Holden R, Mulkerrin E, Sykes D. Opportunistic screening of visual acuity of elderly patients attending outpatient clinics. Age Ageing. 1991 Nov;20(6):392–395. [PubMed]
  • Wormald RP, Wright LA, Courtney P, Beaumont B, Haines AP. Visual problems in the elderly population and implications for services. BMJ. 1992 May 9;304(6836):1226–1229. [PMC free article] [PubMed]
  • Reinstein DZ, Dorward NL, Wormald RP, Graham A, O'Connor I, Charlton RM, Yeatman M, Dodenhoff R, Touquet R, Challoner T. 'Correctable undetected visual acuity deficit' in patients aged 65 and over attending an accident and emergency department. Br J Ophthalmol. 1993 May;77(5):293–296. [PMC free article] [PubMed]
  • MacCuish AC. Early detection and screening for diabetic retinopathy. Eye (Lond) 1993;7(Pt 2):254–259. [PubMed]
  • Brocklehurst JC, Exton-Smith AN, Lempert Barber SM, Hunt LP, Palmer MK. Fracture of the femur in old age: A two-centre study of associated clinical factors and the cause of the fall. Age Ageing. 1978 Feb;7(1):2–15. [PubMed]
  • Grisso JA, Kelsey JL, Strom BL, Chiu GY, Maislin G, O'Brien LA, Hoffman S, Kaplan F. Risk factors for falls as a cause of hip fracture in women. The Northeast Hip Fracture Study Group. N Engl J Med. 1991 May 9;324(19):1326–1331. [PubMed]
  • Wilson A. The red eye: a general practice survey. J R Coll Gen Pract. 1987 Feb;37(295):62–64. [PMC free article] [PubMed]
  • McDonnell PJ. How do general practitioners manage eye disease in the community? Br J Ophthalmol. 1988 Oct;72(10):733–736. [PMC free article] [PubMed]
  • Sheldrick JH, Vernon SA, Wilson A. Study of diagnostic accord between general practitioners and an ophthalmologist. BMJ. 1992 Apr 25;304(6834):1096–1098. [PMC free article] [PubMed]
  • Jones NP, Lloyd IC, Kwartz J. General practitioner referrals to an eye hospital: a standard referral form. J R Soc Med. 1990 Dec;83(12):770–772. [PubMed]
  • Harris A. Health checks for people over 75. BMJ. 1992 Sep 12;305(6854):599–600. [PMC free article] [PubMed]
  • Cullinan TR, Silver JH, Gould ES, Irvine D. Visual disability and home lighting. Lancet. 1979 Mar 24;1(8117):642–644. [PubMed]
  • Klein R, Klein BE, Neider MW, Hubbard LD, Meuer SM, Brothers RJ. Diabetic retinopathy as detected using ophthalmoscopy, a nonmydriatic camera and a standard fundus camera. Ophthalmology. 1985 Apr;92(4):485–491. [PubMed]
  • Hollows FC, Graham PA. Intra-ocular pressure, glaucoma, and glaucoma suspects in a defined population. Br J Ophthalmol. 1966 Oct;50(10):570–586. [PMC free article] [PubMed]
  • Koperski M. How effective is systematic care of diabetic patients? A study in one general practice. Br J Gen Pract. 1992 Dec;42(365):508–511. [PMC free article] [PubMed]
  • Awh CC, Cupples HP, Javitt JC. Improved detection and referral of patients with diabetic retinopathy by primary care physicians. Effectiveness of education. Arch Intern Med. 1991 Jul;151(7):1405–1408. [PubMed]
  • Burns-Cox CJ, Hart JC. Screening of diabetics for retinopathy by ophthalmic opticians. Br Med J (Clin Res Ed) 1985 Apr 6;290(6474):1052–1054. [PMC free article] [PubMed]
  • Harrison RJ, Wild JM, Hobley AJ. Referral patterns to an ophthalmic outpatient clinic by general practitioners and ophthalmic opticians and the role of these professionals in screening for ocular disease. BMJ. 1988 Nov 5;297(6657):1162–1167. [PMC free article] [PubMed]

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