Eye examinations: urgent or scheduled, here are the criteria to follow

An eye examination does not always have the same degree of urgency. A regular check-up for a visual defect, a sudden drop in vision, an injury, a red sore eye or a visual disorder that has suddenly appeared are not equivalent situations. In order to make the criteria for access to examinations clearer and more homogeneous, helping to identify patients who need to be assessed quickly and those who can follow a planned pathway, the Istituto Superiore di Sanità has published the Recommendation of good clinical and care practice 'Clinical appropriateness for access to ophthalmic examinations', with the Italian Association of Ophthalmic Physicians (Aimo) as the lead body. The objective is twofold: to better direct access, speeding up examinations in cases that require immediate attention, and to reduce improper access through planning that also acts on waiting lists.

"This recommendation does not serve to put obstacles between the patient and the ophthalmologist," says Alessandra Balestrazzi, President of Aimo, "On the contrary, it serves to ensure that each person is directed along the most correct path, in the most appropriate time for their problem. In ophthalmology, time can make all the difference: some conditions need to be recognised and treated quickly to protect eyesight".

The document provides clinical criteria to help professionals assess when an eye examination should be urgent, when it should be performed quickly and when it can be scheduled. In particular, the recommendations help to distinguish between signs that require a quick or urgent referral (such as a sudden drop in vision, eye trauma, acute pain, sudden onset double vision, suspicion of a foreign body, burns or injury to the eye), disorders that require specialist evaluation quickly (such as certain cases of persistent red eye sudden changes in vision or symptoms that may indicate retinal pathologies), situations that can be scheduled (periodic check-ups, evaluations for non-acute visual defects or monitoring in patients with chronic conditions), specific pathways for children, infants and people with systemic diseases (in the case of diabetes or hypertension, which can also affect eye health).

"Ophthalmology is an area where early diagnosis can radically change a person's pathway," Balestrazzi continues, "we are proud to have contributed to a document that brings together scientific rigour, clinical practice and the real needs of patients. For the patient it means knowing when it is necessary to move immediately and when, instead, it is correct to schedule a visit. For the healthcare system it means better use of resources and reducing the risk of a serious case waiting too long'.

Waiting lists, on the other hand, are one of the problems most felt by citizens. In ophthalmology, the demand for examinations is very high, partly because many eye diseases increase with age and because some chronic diseases, such as diabetes, require regular check-ups. This is why defining shared criteria can help to improve the organisation of pathways. It is not a question of reducing access to care, but of making it more orderly: those with a higher risk should be answered first, then the scheduled check-ups, always keeping patient safety at the centre. The recommendation can therefore become a useful tool for family doctors, paediatricians, specialists, healthcare facilities and citizens, facilitating clearer communication on access to eye examinations.