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Ophthalmic Services Guidance

The Royal College of Ophthalmologists is the guardian of excellence in ophthalmology. It aims to set standards in all aspects of the delivery of ophthalmic care in the interests of patients and the public. Guidance is provided under various topics. The guidance is intended to inform both ophthalmologists and those managing eye services. Standards of practice are clearly identified. The maintenance of these standards may only be achieved through adequate staffing levels, proper facilities and appropriate managerial support. Ophthalmic care for patients must continuously improve through regular robust audit, professional development and innovation, and training.

Ophthalmic Services Guidance Chapter Brief Description
Clinical Audit and Clinical Effectiveness in Ophthalmology (October 2016) This document aims to provide a simple overview of the principles and practice of clinical effectiveness and clinical audit for ophthalmologists, and should be read in conjunction with the College publication Quality, safety and clinical governance in ophthalmology: an overview.
Eye Care Services for Adults with Learning Disabilities 2015

(September 2015)

The aim of this document is to provide ophthalmologists with guidance and support so as to enable them to provide insightful and quality treatment to patients with LD. The College information can also be supplemented by the General Medical Council’s interactive learning sessions regarding patients with learning disabilities on its website.
Ophthalmic Daycare and Inpatient Facilities (updated May 2012) Provides information and advice on the points to consider when planning satisfactory and safe day surgery
Ophthalmic Instrument Decontamination (updated October 2016) The effective decontamination of re-usable surgical instruments (or other clinical devices used in direct contact with tissues) is essential in minimising the risk of infectious agents.
Emergency eye care in hospital eye units and secondary care Aug 2017 (updated August 2017) A consensus document that provides information on good practice for urgent and emergency secondary emergency ophthalmic care.
Healthcare Informatics (2017) This document intends to provide a glossary and basic introduction to the multiple facets of healthcare informatics and provides references for further reading.
Managing an outbreak of postoperative endophthalmitis (updated July 2016) Advice on the identification and management of an outbreak of post ophthalmic procedure endophthalmitis. The guidance concentrates particularly on cataract surgery, but is also applicable to other intraocular procedures including intravitreal injections. As much is possible is based on published evidence but, in the absence of published high quality evidence for many aspects, expert consensus has been used to make recommendations. A summary sheet and check list is included at the end.
Management of Retinal Detachment (Updated October 2010) The management of acute retinal detachment in the United Kingdom has become increasingly successful with subspecialist VR surgeons taking over the management from the general ophthalmologist.
Prevention of transmission of blood-borne viruses in ophthalmic surgery (Updated April 2010) This paper aims to provide a synopsis of current guidance and published research on safe practice for minimising the risks of transmission of infection during surgery, from the ophthalmologist’s perspective.
Quality standard for people with sight loss and dementia in an ophthalmology department (December 2015) This quality standard has been developed by The Royal College of Ophthalmologists and VISION 2020 UK to help ophthalmology departments provide high quality care for patients with dementia.
Occupational Visual Standards Archived May 2014 For up to date information please visit


Ophthalmic Imaging (November 2016) Ophthalmic imaging is essential to the diagnosis, treatment, and long-term monitoring of many ocular conditions. This document provides an overview of the current state of commercially-available ophthalmic imaging technologies and their clinical applications as things stand at the time of publication and readers should note this is a rapidly changing field.  It also provides recommendations regarding minimum ophthalmic imaging requirements for hospital eye services.  Finally, it touches on a number of important issues related to ophthalmic imaging, including information technology and information governance requirements, and the need for valid informed consent.
Ophthalmic Outpatiemt Department (Updated May 2012) Provides information and advice on the points to consider when planning efficient and quality ophthalmic outpatient services.
Ophthalmic Pathology (Updated July 2016) This Ophthalmic Pathology chapter is based on joint guidance document of The Royal College of Ophthalmologists and The Royal College of Pathologists on referral of ophthalmic pathology specimens.
Ophthalmic Services for Children (Updated August 2012) Summarises the views of the Paediatric Subcommittee  regarding best practice and minimum standards in relation to health services for children with ophthalmic disorders, in keeping with the RCOphth’s Quality Standards /Indicators for Paediatric Ophthalmology.
Delivery of Diabetic Eye Care (March 2009) This chapter addresses issues of provision of care for patients with retinopathy referred to the hospital eye service.
 Quality safety and clinical governance in ophthalmology An overview

(July 2016)

This document aims to provide a simple overview of the principles and systems which currently exist in the UK for quality and safety, and how they have evolved. It is supplemented by other more detailed documents on specific areas. References are, where possible, web-based, to allow members to more easily access them for further reading if interested.
Primary Care Ophthalmology (updated June 2013) This guidance is to help those designing and commissioning eye care to improve the value of their services.  It forms part of a Right Care/QIPP vision of ‘hospital without walls’ for ophthalmic care.
Standards for Virtual Clinics in Glaucoma Care in the NHS Hospital Eye Service (November 2016) There is emerging evidence of the increasing popularity of virtual clinics in secondary care in glaucoma specialties to help deal with increasing patient numbers. There are no clear guidelines for the development of these services, and whilst there is some evidence suggesting this model is equivalent to standard face-to-face care, it is still a relatively new model of service delivery. Thus, as more Trusts start to implement these clinics to cope with capacity issues, this document attempts to define the standards expected of these clinics so that the quality of patient care within the NHS setting is maintained. They fit with The Royal College of Ophthalmologists The Way Forward Project and their use should  help to standardise glaucoma virtual clinic provision across the UK Hospital Eye Service.
Sustainability in Ophthalmology May 2013 (May 2013) Global resources are finite; as this becomes more apparent the concept of sustainability in healthcare is becoming more important. Ophthalmology is no exception and this paper has been created by a group of people from a wide variety of disciplines to inform, guide, provoke thought and offer practical solutions to some of the sustainability issues within ophthalmology. This is a position paper from the College designed for Ophthalmologists, allied professions, other medical specialties and interested lay parties.
Theatres (Updated August 2013) Most eye surgery should be performed in ophthalmic theatres, ideally dedicated for ophthalmic use. In practice it is frequently necessary to share facilities, in which case it is important that contamination risk is kept to a minimum.
Vision Standards for Driving (Updated October 2013) Most of the sensory input to the brain required for driving is visual. However surprisingly, there is little evidence that defects of vision alone cause road accidents. Nevertheless adequate standards of vision do need to be set for drivers on today’s busy roads.


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