Referral patterns of primary care physicians for eye care.
BACKGROUND: There is very little data regarding the referral rates of primary care physicians for eye care. We studied the extent to which primary care physicians follow guidelines and standards that have been set by professional organizations within eye care. METHODS: Forty-eight patients over age 40 years seen during one day in the Primary Care Department of a large, metropolitan hospital were reviewed. RESULTS: Only 12.5 percent of patients seen were referred for eye care. Only 8 percent of those who were diabetic and 13 percent of those with hypertension were referred for eye care, while of each group respectively, 25 percent and 34.8 percent had been seen for eye care in the previous year. Referrals tended to be for acute problems, not for routine monitoring of ocular signs associated with hypertension or diabetes. Only 33.3 percent of the patients had an ocular assessment in the physician's records within the year. In addition, most patients did not have ophthalmoscopy, glaucoma testing, or any other form of vision care during the year. CONCLUSIONS: In this study, referrals for eye care seemed to be driven by acute, symptomatic problems, and to a lesser extent by a known ocular condition. The importance of routine eye care was not reflected in the referral patterns observed in this study.