Bill Harvey: Wheels of confusion
Author: Bill Harvey
When I worked in the hospital eye service all those years ago, I remember being struck by the need for each patient about to undergo surgery to have a large red arrow on their forehead pointing to whichever eye was to be operated upon. When I asked about this Heath Robinson low-tech approach, I was surprised to learn that working on the wrong eye was a perennial problem that required as many precautions as possible to avoid.
Last week we ran a CET article on intravitreal injections. Not too many years ago, this was the sort of article that used to trigger correspondence of the ‘why do opticians need to know about that?’ variety. Not so today, as increasing numbers of optometrists are supporting ophthalmology by undertaking such procedures. This is a trend likely to continue, Covid-19 or not.
With this in mind, I read with interest this week a pre-publication study in the latest issue of the journal Retina called ‘Self-designation of the treated eye before intravitreal injections.’ The paper highlights the fact that increasingly, after a patient has been seen by the vitreoretinal specialist, someone else will undertake the intravitreal injection. The prospective study included 349 consecutive patients who were asked which eye they thought was to have the injection, and were subsequently divided into two groups according to whether or not they identified the correct eye. Normally, what the patient says is compared with the notes before the eye is marked. The study found that a worrying 8.6% of patients said the wrong eye and 7.2% had no idea which eye was to be injected. Inter-professional liaison is our future, but this is a timely reminder of the need for constant cross-checking and communication.
Don’t throw away the red pens yet.