Optimising Emergency Corneal Gluing: Pre-Prepared Packs And A Qr-Linked Video To Improve Sourcing Delays And Trainee Confidence

Corneal perforation is an ophthalmic emergency with immediate risk of irreversible visual loss and structural collapse of the globe. Cyanoacrylate corneal gluing provides a sight- and globe-saving temporising measure by sealing the defect, restoring anterior chamber stability, and reducing microbial ingress. We identified time sensitive delays in patient management and set out several strategies to design a quality improvement project to improve intervention time and resident doctor confidence.

The Emergenct Eye clinuc at the Hinchingbrooke Hospital, North-West Anglia NHS Foundation Trust, Huntingdon, United Kingdom.

The project employed a pre- and post-intervention design. Baseline performance was assessed by timing residents sourcing instruments and materials required for a corneal gluing procedure from standard stock. Trainee confidence and perceived preparedness were evaluated using structured questionnaires. The intervention consisted of pre-assembled corneal gluing packs containing all required equipment, accompanied by a QR code linking to a concise procedural instructional video. Post-intervention timing metrics and qualitative feedback on usability and confidence were collected to assess impact.

Baseline median equipment assembly time was 15 minutes (range 8-20). Trainee’s mean confidence in management of corneal gluing was 6/10. Following our intervention of pre-assembled packs and QR-linked video, we found the median time taken decreased to 35seconds (range 25-50), equating to a 96% reduction and markedly improved emergency readiness. Trainee confidence also improved to 9/10 post-intervention, reporting improved procedural understanding and ease in their cognitive load when approaching emergency cases of corneal perforation.

Standardisation of emergency corneal gluing through pre-assembled procedural packs and a QR-linked instructional video significantly reduced treatment delays and improved trainee confidence in managing corneal perforations. By streamlining access to equipment and guidance, this low-cost intervention enhances preparedness for a sight-threatening emergency and promotes safer, more efficient patient care. The model is easily reproducible and scalable across ophthalmic units aiming to optimise delivery of other time-critical procedures.