Endophthalmitis following intravitreal injections administered by junior medical officers in rural Western Australia

Author:

Lee Jackson Chee Chea1ORCID,Razavi Hessom1ORCID,Nejatian Marcel Maziyar1ORCID,Drinkwater Jocelyn1ORCID,Turner Angus Warwick1ORCID

Affiliation:

1. Lions Outback Vision, Centre for Ophthalmology and Visual Science University of Western Australia and the Lions Eye Institute Perth Western Australia Australia

Abstract

AbstractBackgroundPatients in rural Australia have limited access to intravitreal treatments due to a maldistribution of the ophthalmology workforce. To improve access, a novel outreach service model was implemented whereby junior medical staff administered intravitreal injections under a supervising ophthalmology consultant. This model involves outreach visits in hospitals, mobile clinics and a remote hub with intravitreal injections administered by junior doctors overseen by an ophthalmologist. The article explores the safety of this approach with respect to the rate of post‐injection endophthalmitis.MethodsA retrospective audit was conducted by the Lions Outback Vision outreach ophthalmology service from 2017 to mid‐2023. The number of injections, locations, diagnoses, intravitreal agents used, designation of administering doctor and cases of endophthalmitis were reviewed.ResultsA 12 632 intravitreal injections were administered across 32 locations throughout rural Western Australia in the 6.5‐year period. Three cases of endophthalmitis occurred representing a rate of 0.0237%.ConclusionThe rate of endophthalmitis in the outreach service is comparable to other centres. The outreach model with supervising ophthalmology consultant support in person or via telehealth and administration of injections by junior medical staff has improved access for underserved or marginalised populations.

Publisher

Wiley

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