Background
Purpose
Methods
Data sources and searches
Study selection
Data extraction and quality assessment
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Country
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Condition(s) – the eye condition(s) for which the appropriateness of care was assessed
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Professions – the health professions delivering the care of the assessed eye condition
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Methods – the method used to assess the appropriateness of eye care delivered
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Sample size
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Response rate
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Evidence sources – the reference standard used to assess the appropriateness of eye care delivered
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Settings – classification based on whether study was conducted in hospital or independent practice
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Number of sites – the number of sites that the study was conducted at
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Timing – the timing and visit types assessed in the article (e.g. at diagnosis, follow-up, etc)
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Percentage of encounters with appropriate eye care – the number of quality indicators met over the total number of relevant quality indicators
Data synthesis and analysis
Results
Country | Evidence sources | Year | Professions | Outcomes | Methods | Overall qualitya | Author (reference) | nb |
---|---|---|---|---|---|---|---|---|
Glaucoma | ||||||||
UK | 2013 | Ophthalmologist | Current practice pattern | Record review | Strong | Fung et al. [26] | 101 | |
UK | Clinical practice guidelines [25] | 2012 | Ophthalmologist & optometrist | Guidelines adherence | Record review | Weak | Chawla et al. [27] | 200 |
UK | 2012 | Optometrist | Guidelines adherence | Record review | Moderate | Khan et al. [29] | 114 | |
UK | Clinical practice guidelines [30] | 2012 | Optometrist | Validation of self-reported practice | Interview with practitioner and unannounced standardised patient | Moderate | Theodossiades et al. [31] | 34 |
UK | Clinical practice guidelines [25] | 2011 | Ophthalmologist | Current practice pattern | Practitioner Survey | Moderate | Stead et al. [32] | 626 (69%) |
UK | 2009 | Optometrist | Quality of referral letter | Record review | Moderate | Scully et al. [35] | 121 | |
UK | Experts’ opinions | 2012 | Optometrist | Diagnostic accuracy | Clinical agreement with expert | Moderate | Marks et al. [36] | 145 |
UK | Experts’ opinions | 2011 | Optometrist | Diagnostic accuracy | Record review | Moderate | Ho and Vernon [37] | 140 |
UK | Experts’ opinions | 2011 | Optometrist | Quality of referral | Record review | Moderate | Shah and Murdoch [38] | 110 |
UK | Experts’ opinions | 2010 | Optometrist | Feasibility of shared care | Record review | Strong | Syam et al. [39] | 1184 |
UK | Experts’ opinions | 2010 | Optometrist | Quality of referral | Record review | Weak | Lockwood et al. [40] | 441 |
UK | Experts’ opinions | 2007 | Ophthalmologist & optometrist | Diagnostic accuracy | Clinical agreement with expert | Strong | Azuara-Blanco et al. [41] | 100 |
UK | Experts’ opinions | 2006 | Optometrist | Quality of referral | Record review | Weak | Patel et al. [42] | 376 |
UK | Experts’ opinions | 2006 | Optometrist & associate specialists | Diagnostic accuracy | Clinical agreement with expert | Moderate | Banes et al. [43] | 350 |
USA | 2016 | Ophthalmologist | Current practice pattern | Record review | Moderate | Solano-Moncada et al. [45] | 250 | |
USA | Clinical practice guidelines [44] | 2016 | Ophthalmologist & optometrist | Current practice pattern | Claims data | Strong | Elam et al. [46] | 56,675 |
USA | Clinical practice guidelines [47] | 2015 | Ophthalmologist | Diagnostic accuracy | Record review | Moderate | Zebardast et al. [48] | 212 |
USA | Clinical practice guidelines [49] & experts’ opinions | 2013 | Ophthalmologist | Guidelines adherence | Record review | Strong | Ong et al. [50] | 103 |
USA | Clinical practice guidelines [44] | 2012 | Ophthalmologist & optometrist | Current practice pattern | Claims data | Moderate | Swamy et al. [51] | 143,374 |
USA | Clinical practice guidelines [49] | 2007 | Ophthalmologist | Guidelines adherence | Claims data, record review, practitioner survey and patient survey | Moderate | Quigley et al. [52] | 300 |
USA | Clinical practice guidelines [53] | 2006 | Ophthalmologist | Current practice pattern | Claims data | Strong | Coleman et al. [54] | 4427 |
Australia & NZ | Clinical practice guidelines [55] | 2015 | Optometrist | Current practice pattern | Practitioner Survey with case vignette | Moderate | Zangerl et al. [56] | 818 (18%) |
Australia & NZ | 2008 | Ophthalmologist | Current practice pattern | Practitioner Survey | Strong | Liu [59] | 627 (78%) | |
Scotland | 2015 | Optometrist | Quality of referral | Record review | Strong | El-Assal et al. [61] | 1622 | |
Scotland | Clinical practice guidelines [60] | 2009 | Optometrist | Quality of referral | Record review | Moderate | Ang et al. [62] | 303 |
Canada | Clinical practice guidelines [63] | 2014 | Ophthalmologist & optometrist | Quality of referral letter | Record review | Moderate | Cheng et al. [64] | 200 |
Germany | Clinical practice guidelines [57] | 2008 | Ophthalmologist | Guidelines adherence | Practitioner Survey | Moderate | Vorwerk et al. [65] | 335 (12%) |
Singapore | Clinical practice guidelines [66] | 2008 | Ophthalmologist | Current practice pattern | Practitioner Survey | Strong | Ang et al. [67] | 126 (80%) |
Diabetic retinopathy | ||||||||
Australia | Clinical practice guidelines [68] | 2011 | Optometrist | Current practice pattern | Practitioner Survey | Weak | Slater and Chakman [69] | 985 (26%) |
Australia | Clinical practice guidelines [70] | 2011 | Optometrist | Current practice pattern | Practitioner Survey with case vignette | Strong | Ting et al. [71] | 568 (57%) |
Australia | Clinical practice guidelines [70] | 2010 | Ophthalmologist | Guidelines adherence | Practitioner Survey with case vignette | Strong | Yuen et al. [72] | 480 (63%) |
NZ | Clinical practice guidelines [73] | 2012 | Optometrist | Guidelines adherence | Record review | Strong | Hutchins et al. [74] | 157 |
USA | Clinical practice guidelines [75] | 2012 | Ophthalmologist & optometrist | Current practice pattern | Patient survey | Strong | Chou et al. [76] | 29,495 |
USA | Clinical practice guidelines [77] | 2010 | Ophthalmologist | Guidelines adherence | Record review | Strong | Tseng et al. [78] | 70 |
Hong Kong | Clinical practice guidelines [79] | 2016 | General practitioner | Guidelines adherence | Practitioner Survey | Strong | Wong et al. [80] | 414 (13%) |
Bahrain | Clinical practice guidelines [81] | 2014 | General practitioner | Guidelines adherence | Record review | Strong | Al-Ubaidi et al. [82] | 200 |
Switzerland | Clinical practice guidelines [83] | 2013 | General practitioner | Guidelines adherence | Record review | Moderate | Burgmann et al. [84] | 275 |
UK | Clinical practice guidelines [85] | 2011 | General practitioner | Guidelines adherence | Record review | Strong | Mc Hugh et al. [86] | 3010 |
Brazil | Clinical practice guidelines [87] | 2007 | General practitioner | Current practice pattern | Practitioner Survey | Weak | Preti et al. [88] | 168 (34%) |
Age-related macular degeneration | ||||||||
Italy | 2016 | Ophthalmologist | Guidelines adherence | Interview with patient | Moderate | Parodi et al. [93] | 283 | |
Turkey | 2015 | Ophthalmologist | Current practice pattern | Practitioner Survey | Moderate | Muhammed et al. [95] | 249 (21%) | |
UK | 2013 | Ophthalmologist & optometrist | Current practice pattern | Practitioner Survey with case vignette | Weak | Lawrenson and Evans [100] | 1468 (15%) | |
USA | 2008 | Ophthalmologist | Current practice pattern | Patient survey | Moderate | Charkoudian et al. [103] | 332 (99%) | |
Cataract | ||||||||
UK | Clinical practice guidelines [104] | 2011 | Ophthalmologist | Current practice pattern | Practitioner Survey | Weak | Gomaa and Liu [105] | 158 (53%) |
UK | Clinical practice guidelines [106] | 2009 | Optometrist & general practitioner | Quality of referral letter | Record review | Strong | Park et al. [107] | 124 |
UK | Clinical practice guidelines [108] | 2006 | Optometrist | Quality of referral letter | Record review | Moderate | Lash et al. [109] | 351 |
USA | Clinical practice guidelines [110] | 2009 | Resident ophthalmologist | Guidelines adherence | Record review | Strong | Niemiec et al. [111] | 129 |
Preventative eye care | ||||||||
UK | 2009 | Optometrist | Current practice pattern | Unannounced Standardised patient | Moderate | Shah et al. [115] | 100 | |
UK | 2009 | Optometrist | Current practice pattern | Unannounced Standardised patient | Moderate | Shah et al. [118] | 102 | |
UK | 2008 | Optometrist | Current practice pattern | Unannounced Standardised patient | Moderate | Shah et al. [120] | 100 | |
Australia | 2015 | Optometrist | Current practice pattern | Practitioner Survey | Moderate | Downie and Keller [129] | 283 (6.7%) | |
Dry eye | ||||||||
Australia | 2013 | Optometrist | Guidelines adherence | Practitioner Survey | Moderate | Downie et al. [132] | 144 (22%) | |
USA | Clinical practice guidelines [133] | 2010 | Ophthalmologist | Guidelines adherence | Record review | Weak | Lin et al. [134] | 178 |
All ocular conditions at A&E | ||||||||
UK | Experts’ opinions | 2007 | Optometrist | Diagnostic accuracy | Clinical agreement with expert | Moderate | Hau et al. [135] | 150 |
Amblyopia | ||||||||
USA | 2013 | Ophthalmologist | Guidelines adherence | Record review | Moderate | Jin et al. [138] | 123 | |
Esotropia | ||||||||
USA | Clinical practice guidelines [139] | 2010 | Ophthalmologist | Guidelines adherence | Record review | Weak | Gupta et al. [140] | 200 |
Non-infectious uveitis | ||||||||
USA | Clinical practice guidelines [141] | 2011 | Ophthalmologist & rheumatologist | Current practice pattern | Record review and practitioner survey | Moderate | Nguyen et al. [142] | 580 |
Country | Year | Health Practitioner | Timing | Domain of care | Author (reference) | |||||
---|---|---|---|---|---|---|---|---|---|---|
History taking | Physical examination | Management | Recall period | Referral | Patient education | |||||
Glaucoma | ||||||||||
UK | 2013 | Ophthalmologist | All visits (at least up to 17.5 years) | 0,87% (1)a | Fung et al. [26] | |||||
UK | 2012 | Optometrist | First visit | 74–100% (6) | 96% (1) | Chawla et al. [27] | ||||
First follow-up visit | 88% (1) | 94–100% (3) | 92% (2) | |||||||
Ophthalmologist | First visit | 10–100% (6) | 100% (1) | |||||||
First follow-up visit | 24% (1) | 8–100% (3) | 66–86% (2) | |||||||
UK | 2012 | Optometrist | Referral letter for glaucoma diagnosis | 70% (1)b 4–99% (6)c | Khan et al. [29] | |||||
UK | 2012 | Optometrist | Results of interview | 77% (1) | 19–98% (4) | Theodossiades et al. [31] | ||||
First visit of standardised patient | 41% (1) | 3–100% (4) | ||||||||
UK | 2011 | Ophthalmologist | N/A | 23% (1) | Stead et al. [32] | |||||
UK | 2009 | Optometrist | Referral letter for glaucoma diagnosis | 27–100% (14)c | Scully et al. [35] | |||||
UK | 2012 | Optometrist | First full visit | 91–98% (1) | 97% (1) | 87% (1)2 | Marks et al. [36] | |||
UK | 2011 | Optometrist | All follow-up visits | 96% (1) | 99% (1) | 93% (1) | Ho and Vernon [37] | |||
UK | 2011 | Optometrist | Referral letter for glaucoma diagnosis | 25% (1)b | Shah and Murdoch [38] | |||||
UK | 2010 | Optometrist | All visits | 93% (1) | 86% (1) | Syam et al. [39] | ||||
UK | 2010 | Optometrist | Referral letter for glaucoma diagnosis | 37% (1)b 72–99% (3)c | Lockwood et al. [40] | |||||
UK | 2007 | Optometrist | First visit | 85% (1) | Azuara-Blanco et al. [41] | |||||
Ophthalmologist | First visit | 83% (1) | ||||||||
UK | 2006 | Optometrist | Referral letter for glaucoma diagnosis | 45% (1)b | Patel et al. [42] | |||||
UK | 2006 | Optometrist | All follow-up visit | 62–98% (5) | 72–97% (5) | 79% (1) | Banes et al. [43] | |||
Associate specialists | All follow-up visit | 54–100% (5) | 71–99% (5) | 73% (1) | ||||||
USA | 2016 | Ophthalmologist | All follow-up visits | 68% (1) | Solano-Moncada et al. [45] | |||||
USA | 2016 | Ophthalmologist & optometrist | All visits within 2 years after glaucoma diagnosis | 27–74% (2) | Elam et al. [46] | |||||
USA | 2015 | Resident ophthalmologist | Third (or more) follow-up visit | 88% (1) | 62–100% (5) | 74% (1) | Zebardast et al. [48] | |||
Faculty ophthalmologist | Third (or more) follow-up visit | 100% (1) | 87–100% (5) | 100% (1) | ||||||
USA | 2013 | Resident ophthalmologist | First follow-up visit | 49–97% (5) | 93–100% (4) | 82–100% (6) | 96–97% (2) | 16% (1) | 5% (1) | Ong et al. [50] |
USA | 2012 | Ophthalmologist & optometrist | All visits within 3 years after glaucoma or glaucoma suspect diagnosis | 12–34% (2) | Swamy et al. [51] | |||||
USA | 2007 | Ophthalmologist | First claim for a prostaglandin prescription | 50–90% (5) | 19% (1) | 100% (1) | 38% (1) | Quigley et al. [52] | ||
USA | 2006 | Ophthalmologist | All visits within 5 years before surgery for glaucoma | 49% (1) | Coleman et al. [54] | |||||
Australia & NZ | 2015 | Optometrist (Australia) | N/A | 99% (1) | 25–100% (10) | Zangerl et al. [56] | ||||
Optometrist (NZ) | N/A | 100% (1) | 27–100% (10) | |||||||
Australia & NZ | 2008 | Ophthalmologist | N/A | 13–96% (4) | Liu [59] | |||||
Scotland | 2015 | Optometrist | Referral letter for glaucoma diagnosis BEFORE guidelines published | 62% (1)b 33–85% (3)c | El-Assal et al. [61] | |||||
Referral letter for glaucoma diagnosis AFTER guidelines published | 76% (1)b 76–81% (3)c | |||||||||
Scotland | 2009 | Optometrist | Referral letter for glaucoma progression BEFORE guidelines published | 18% (1)b 2–94% (7)c | Ang et al. [62] | |||||
Referral letter for glaucoma progression AFTER guidelines published | 32% (1)b 24–93% (7)c | |||||||||
Canada | 2014 | Ophthalmologist | Referral letter for glaucoma diagnosis | 10–100% (16)c | Cheng et al. [64] | |||||
Optometrist | Referral letter for glaucoma diagnosis | 7–100% (16)c | ||||||||
Germany | 2008 | Ophthalmologist | N/A | 96% (1) | Vorwerk et al. [65] | |||||
Singapore | 2008 | Ophthalmologist | N/A | 75–93% (2) | Ang et al. [67] | |||||
Diabetic retinopathy | ||||||||||
Australia | 2011 | Optometrist | N/A | 83–99% (2)b | Slater and Chakman [69] | |||||
Australia | 2011 | Optometrist | N/A | 43–96% (6) | 23–89% (2) | 6–98% (12)d | Ting et al. [71] | |||
Australia | 2010 | Ophthalmologist | N/A | 41–55% (4) | 49–90% (2) | 56–94% (2) | 38–71% (10)d | Yuen et al. [72] | ||
NZ | 2012 | Optometrist | Fundus screening visit | 60% (1)b | Hutchins et al. [74] | |||||
USA | 2012 | Ophthalmologist & optometrist | N/A | 71% (1) | Chou et al. [76] | |||||
USA | 2010 | Resident ophthalmologist | First ever diabetic retinopathy examination | 41–57% (5) | 0–100% (7) | 70–79% (2) | 69–70% (2) | 0–27% (3) | Tseng et al. [78] | |
Hong Kong | 2016 | General practitioner | N/A | 33% (1) | 27% (1) | Wong et al. [80] | ||||
Bahrain | 2014 | General practitioner at general practitioner clinic | All follow-up visits within previous 12 months | 0% (1)e | Al-Ubaidi et al. [82] | |||||
General practitioner at diabetes care clinic | All follow-up visits within previous 12 months | 87% (1)e | ||||||||
Switzerland | 2013 | General practitioner | First hospitalisation | 31% (1)e | Burgmann et al. [84] | |||||
UK | 2011 | General practitioner | Second diabetic visit | 71% (1)e | Mc Hugh et al. [86] | |||||
Brazil | 2007 | General practitioner | N/A | 34–87% (2)e | Preti et al. [88] | |||||
Age-related Macular Degeneration | ||||||||||
Italy | 2016 | Ophthalmologist | N/A | 44% (1) | Parodi et al. [93] | |||||
Turkey | 2015 | Ophthalmologist | N/A | 23% (1) | Muhammed et al. [95] | |||||
UK | 2013 | Ophthalmologist & optometrist | N/A | 21–32% (2) | 28–70% (5) | 49% (1) | Lawrenson and Evans [100] | |||
USA | 2008 | Ophthalmologist | N/A | 76% (1) | Charkoudian et al. [103] | |||||
Cataract | ||||||||||
UK | 2011 | Ophthalmologist | N/A | 51–99% (3) | Gomaa and Liu [105] | |||||
UK | 2009 | Optometrist | Referral letter for cataract surgery | 0–100% (10)c | Park et al. [107] | |||||
General practitioner | Referral letter for cataract surgery | 0–100% (10)c | ||||||||
UK | 2006 | Optometrist | Referral letter for cataract surgery | 48% (1)c | Lash et al. [109] | |||||
USA | 2009 | Resident ophthalmologist | Preoperative care visits for first cataract surgery | 73–100% (4) | 59–100% (9) | 0–100% (9) | Niemiec et al. [111] | |||
All postoperative follow-up visits for first cataract surgery | 14–78% (6) | 77–100% (7) | 98% (1) | 98% (1) | 43% (1)b | 98% (1) | ||||
Preventative eye care | ||||||||||
UK | 2009 | Optometrist | First visit | 95% (1) | 0–100% (5) | Shah et al. [115] | ||||
UK | 2009 | Optometrist | First visit | 26–87% (8) | 24–99% (10) | 29% (1) | Shah et al. [118] | |||
UK | 2008 | Optometrist | First visit | 1–100% (14) | 59–100% (8) | 14–80% (6) | Shah et al. [120] | |||
Australia | 2015 | Optometrist | N/A | 47–55% (2) | 62–80% (2) | Downie and Keller [129] | ||||
Dry eye | ||||||||||
Australia | 2013 | Optometrist | N/A | 4–93% (3) | Downie et al. [132] | |||||
USA | 2010 | Ophthalmologist | Initial diagnosis visit BEFORE guidelines revised | 6–99% (12) | 6–100% (12) | 5–90% (5) | 48% (1)b | 47–89% (3) | Lin et al. [134] | |
Initial diagnosis visit AFTER guidelines revised | 6–100% (16) | 6–100% (13) | 0–100% (7) | 33% (1)b | 33–89% (4) | |||||
All ocular conditions at A&E | ||||||||||
UK | 2007 | Optometrist | First visit | 91% (1) | Hau et al. [135] | |||||
Amblyopia | ||||||||||
USA | 2013 | Ophthalmologist | Initial visit | 12–24% (2) | Jin et al. [138] | |||||
Esotropia | ||||||||||
USA | 2010 | Ophthalmologist | Initial esotropia evaluation | 64% (4)f | 99.6% (6)f | 94% (4)f | 94% (2)f | Gupta et al. [140] | ||
70% (4)g | 90% (6)g | 94% (4)g | 94% (4)g | |||||||
Non-infectious uveitis | ||||||||||
USA | 2011 | Ophthalmologist & rheumatologist | All visits since initial diagnosis | 12–23% (2) | Nguyen et al. [142] |