Module guide · Clinical

Ophthalmology

An eye service where every number is recorded per eye: acuity, pressure, disc appearance, the prescription that came out of it, and whether the patient ever collected their glasses.

Overview Dashboard Eye examinations Optical prescriptions Procedures Imaging & fields Patient eye record Analytics & export Good practices

What this module is for

Examination, prescribing, theatre and imaging for the eye service, with the pressure and disc findings that decide who gets watched.

Who uses it

Ophthalmologists, optometrists and orthoptists, with administrators and directors for the analytics.

Where to find it

Open Ophthalmology from the sidebar. Six screens: a dashboard, Examinations, Optical prescriptions, Procedures, Imaging & visual fields, and a per-patient eye record, plus Analytics and Import & export.

1
Open an examination
It opens as a draft; only a visual acuity or an assessment is needed before it can be finalised.
2
Record acuity and pressure per eye
Write what you measured, and record which instrument the pressure came from.
3
Order what you need
OCT, visual fields, biometry or photography, tracked from ordered through performed to reported.
4
Prescribe or operate
Issue an optical prescription, or book a theatre case, laser session or intravitreal injection.
5
Follow up
Uncollected prescriptions and overdue reviews surface on their own queues.

A few terms you'll see throughout

IOP is intraocular pressure, in mmHg. Cup-to-disc ratio describes the optic nerve head; a large or asymmetric cup is a glaucoma suspicion. OCT is optical coherence tomography. Acuity may be written as 6/9, 20/40, CF (counting fingers), HM (hand movements), LP or NLP (light perception, or none).

Dashboard

The eye service over a chosen window, plus the two findings worth chasing.

Flags and queues

Field	What it means
Raised pressure	One or both eyes measured at 21 mmHg or above in this window. A measurement, not a diagnosis.
Suspicious disc	A cup of 0.6 or more, or 0.2 of asymmetry between the eyes.
Uncollected prescriptions	Issued more than two weeks ago, still in date, never dispensed. Every row is a patient going without.
Drafts	Examinations started and never finalised.

Figures cover examinations recorded at this establishment only.

Eye examinations

Search by number, complaint, assessment or code, and narrow by type, status and date.

What an examination records

Field	What it means
Visual acuity	Per eye, unaided and corrected. Write what you measured: 6/9, 20/40, CF 2m, HM, LP or NLP.
Intraocular pressure	Per eye, with the instrument recorded — it changes what the number means.
Refraction	Sphere, cylinder, axis and addition, per eye.
Anterior segment and fundus	Findings per eye, including the cup-to-disc ratio.
Assessment and plan	Free text, plus the review interval.

Draft — opened, still editable

Finalised — complete; needs an acuity or an assessment

Amended — reopened and changed, with the reason kept

Cancelled — withdrawn

Optical prescriptions

Spectacles and contact lenses, and whether the patient collected them.

Enter a power for at least one eye. Left blank, the prescription is valid for two years from the date of issue. A prescription is marked dispensed when the patient collects — which is what makes the uncollected queue meaningful.

The uncollected queue is a clinical list, not an administrative one

Issued more than two weeks ago, still in date and never dispensed: each of those rows is somebody who was told they needed glasses and does not have them.

Ophthalmic procedures

Theatre cases, laser sessions and intravitreal injections.

Which eye is required and has no default — there is no safe guess for laterality in an eye service. Procedures carry an operative note, and move through the usual planned, completed and cancelled states.

Imaging and visual fields

OCT, fields, biometry and photography — ordered, performed and reported here.

A study is recorded as performed once a time is given, and as reported once findings are. That means the worklist between the two states is simply the studies that have been done and not yet read.

Patient eye record

Everything the eye service holds on one patient, with the trends that decide what happens next.

Search by name or medical record number. The record brings together the patient's examinations, prescriptions, procedures and studies, and plots acuity and pressure over time per eye.

Analytics, import and export

Activity and outcome over the selected period.

What is measured

Field	What it means
Average IOP	mmHg, both eyes averaged per patient.
Dispensing rate	Prescriptions collected as a share of those issued.
Follow-up compliance	Of the reviews that came due, how many were attended.
IOP distribution	Counted per eye — an eye at 30 mmHg beside one at 14 is the case worth finding.

Examinations can be imported in bulk, which is what an outreach screening camp produces. Extracts come as CSV, Excel or PDF: CSV round-trips with the import, Excel keeps numbers as numbers, and the PDF is the document you sign and file.

Good practices

Record the instrument with the pressure

Applanation, rebound and non-contact readings are not interchangeable. The number alone is only interpretable if the next clinician knows how it was taken.

Write the acuity you actually measured

CF, HM, LP and NLP are real results. Rounding them to a fraction the chart cannot support loses the only signal that matters in a very low-vision eye.

Raised pressure is a measurement, not a diagnosis

The dashboard flag says an eye measured at or above 21 mmHg in this window. It exists to make sure somebody looks — not to label the patient.

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