The influence of counselling on patient return following uncomplicated posterior vitreous detachment

Abstract

Purpose. To investigate the effect of patient counselling together with the use of information leaflets on the number of return visits for patients with acute, symptomatic, uncomplicated posterior vitreous detachment (PVD). Methods. The study group comprised the first 50 patients diagnosed with uncomplicated PVD in 1998 when a standard protocol of structured patient counselling and leaflet distribution was employed following diagnosis of PVD. The control group comprised the first 50 patients in 1997 diagnosed with uncomplicated PVD before structured patient counselling was in place. A retrospective analysis of casualty case notes was made comparing the two groups. The number of eye casualty attendances within 1 year of first presentation with PVD was compared in the two groups. Results. Seven patients from the control group returned because of photopsia or floaters; 3 of the 7 returned with no change in their original symptoms. Six patients from the study group returned. All had a definite change in their symptoms of photopsia or floaters. No patient in the study group who returned had old or persistent symptoms. Statistical analysis comparing return visits of patients with no change in symptoms in the two groups by Fisher's Exact Test gave a p value of 0.13. Conclusion. Patients counselled following uncomplicated PVD did not return to eye casualty in the absence of new symptoms. Patients counselling is an important part of the management of PVD because it makes patients aware of which symptoms are important predictors of serious vitreoretinal pathology.