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Empowering doctors, improving vision, increasing satisfaction!

Poster Details

First Author: Z.Thng SINGAPORE

Co Author(s):    S. Wiryasaputra   L. Lee                 

Abstract Details

Purpose:

Cataract surgery is the commonest procedure in Ophthalmology. Patients now have a wide range of intraocular lens (IOL) implants to choose from to suit their individual needs. Often, the counseling is less than ideal in a busy clinic setting and junior doctors may not be confident enough to deal with the subject. In reality, most times, the surgeons make the decision unilaterally. The purpose of this project is to understand the current competency levels of junior doctors in terms of IOL counselling and the difficulties they face and to develop a patient information sheet (PIS) to guide counseling.

Setting:

Tan Tock Seng Hospital

Methods:

A questionnaire was first administered to junior doctors involved directly with counseling patients regarding IOL for cataract surgery. These include medical officers, junior residents and our resident physicians. The questionnaire sought to establish the level of competency of the doctors, the difficulties they face and suggestions they have to improve the current counseling process. The second stage of the project was to incorporate the above findings in the development of a comprehensive PIS regarding IOL choice to aid doctors in the counseling

Results:

18 responded with 66.6% spending 5 minutes or less during the counselling process. 38.9% felt that the current process was insufficient. 83.4% were confident in discussing anisometropia whereas 33.3% and 22.2% were confident in discussing toric and multifocal IOL implants respectively. The reason is because the patients junior doctors counsel are government subsidized patients who do not qualify for toric or multifocal IOL. This is also a blind spot in their training. 83.3% believe a more comprehensive PIS will be beneficial. Others feel patients will have difficulty grasping medical intricacies and will defer to the doctor to make the decision.

Conclusions:

In conclusion, junior doctors are extensively involved in counselling patients regarding choice of IOL implants for cataract surgery. The current state has revealed knowledge gaps and logistical limitations like lack of consultation time. Most junior doctors are in favour of enhanced training and a more comprehensive PIS to guide the discussion with cataract surgery patients. This is especially so when they are keen to select a toric/multifocal IOL implant. However, it is important to note counselling remains a highly individualized process and some may not grasp the finer details and are happy to let clinicians exercise their best judgement.

Financial Disclosure:

NONE

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