"Transformational Change: Nurses Substituting for Ophthalmologists for Intravitreal Injections – a Quality-Improvement Report" Published by Dove Medical Press

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Neovascular (or wet) age-related macular degeneration (AMD) can now be treated by intravitreal injections. As capacity for such patient care is under pressure we describe nurses providing such intravitreal injections.

A joint Quality Improvement Report from Ophthalmology Departments at Bolton NHS Foundation Trust and East Lancashire Hospitals NHS Trust describes experience with anti-vascular endothelial growth factor (anti-VEGF) medication given by nurses by injection into the vitreous body of the eye. Such intravitreal injections are effective for controlling or reversing loss of vision from several retinal diseases. However such anti-VEGF injections are only approved when given by ophthalmic surgeons. The eye patients treated at both hospitals were mostly patients with neovascular age-related macular degeneration (nAMD) and which is the leading cause of blindness in Europe. Some patients with diabetic macular edema (or oedema) and retina vein occlusions also received such nurse administered treatments. Diabetic macular edema (DME) is the leading cause of blindness in the working age group in developed economies. Occulsions of retinal veins is the 3rd leading cause of blindness from vascular disorders of the retina after wet-AMD and DME.

The publication in Clinical OphthalmologyTransformational change: nurses substituting for ophthalmologists for intravitreal injections – a quality-improvement report” is one of the first publications describing nurses giving such intravitreal injections in the peer reviewed literature.

Mr Simon Kelly, Ophthalmic Surgeon at the Royal Bolton Hospital and corresponding author of the publication said, “Such treatments are reducing blindness from nAMD at population levels when provided in a timely pattern. However such frequent treatments can be a strain on already hard pressed ophthalmology services. Furthermore the UK has the lowest ratio of ophthalmic surgeons per head of population in Europe and many ophthalmic departments lacked capacity to treat local patients with such novel medications in NHS care despite these treatments being approved by NICE. We present our solution as a quality improvement report.”

Mrs Salwa Abugreen, Ophthalmic Surgeon at East Lancashire Hospitals NHS Trust and co-author of the publication said, “We describe our experience of four experienced nurses substituting for ophthalmologists to undertake intravitreal anti-VEGF injections at our two adjacent NHS district hospitals. Use of such nurses for intravitreal injections is one transformational solution to cope with the burdens on retinal services. Patient satisfaction survey demonstrated very high score for nurse injector.”

Clinical Ophthalmology is an international, peer reviewed, open access journal covering all subspecialties within ophthalmology.

Dove Medical Press Ltd is a privately held company specializing in the publication of Open Access peer-reviewed journals across the broad spectrum of science, technology and especially medicine.

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Angela Jones
Dove Medical Press
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