CLINICAL RISK REDUCTION


Pathways in sight M


Dr Mark Wright champions the use of a unique set of diagnostic algorithms for non-specialists faced with common ophthalmological complaints


OST UK physicians including GPs and accident and emergency doctors will have had between two and 12 days ophthalmology


attachment during their entire undergraduate training1


, leaving them inexperienced and wary of


dealing with patients presenting with eye problems. Red eye is a common presenting complaint in


patients attending A&E, optometrists and GPs and has been reported to account for 0.9–1.5 per cent of GP consultations.2


be difficult for non-experts, given the diversity of possible diagnoses ranging from self-resolving bacterial conjunctivitis to sight-threatening acute angle closure glaucoma (AACG). Tere are many excellent ophthalmology


textbooks which give the novice the appropriate knowledge, however very few indicate how to apply it. For this reason I have developed along with colleagues a series of diagnostic algorithms (Edinburgh Diagnostic Algorithms) for the three


16 Making the correct diagnosis can


most commonly encountered scenarios: red eye(s), visual loss and diplopia.


Diagnostic frameworks Tese diagnostic algorithms allow the inexperienced clinician (in ophthalmological terms) to start to utilise and build upon their existing knowledge by consulting a framework which represents the thought processes of their more experienced colleagues. Algorithms are, therefore, simply a user-friendly version of these diagnostic and/or treatment thought processes. Algorithms are always a compromise between


having enough detail to cover the most commonly encountered diagnoses while remaining simple enough to use. Tey rely upon the clinician being able to clarify the history and elicit the clinical signs which act as signposts on the road to diagnostic nirvana. How successful are the Edinburgh Diagnostic Algorithms?


SUMMONS


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