Letters : April 21

Referral guidelines

In response to the letter from Chris Hemmerdinger (Optician, April 7) referring to my article on scleritis, I thank my colleague for his gracious compliments and constructive comments. My sole objective for including possible referral guidelines was to provide some additional guidance for optometrists in the community when referring patients with scleritis, an area I felt needed covering due to the general lack of advice from hospitals around the country.

Where guidelines, if issued, simply group conditions into routine, urgent or emergency, with no proviso for grading the severity of the condition, this leads to a situation I and many of my colleagues have found vague and variable.

The guidelines included were produced in consultation with a professor of ophthalmology at St Thomas' Hospital, London, and though I do accept that they are biased towards areas fortunate enough to have separate eye hospitals they can be used as a basis for suitable referral.

While it would have been ideal to produce universal guidelines for every area, that simply wasn't possible in one article. The guidelines, therefore, are meant to be used appropriately depending on the local health care resources available to that practitioner.

Robert Petrarca
London