Using Photo Advice & Guidance for Ophthalmology

Published: 27th April 2021
We recently caught up with Optometrists Ryan Desai and Dilesh Makwana, who both work in the NHS Coventry and Rugby CCG area to find out how they use Photo Advice & Guidance to manage patient conditions. Dilesh, is a community Optometrist who uses Photo Advice & Guidance via the Consultant Connect App to request advice from Ryan and his colleagues.
Using Photo Advice & Guidance for Ophthalmology - Consultant Connect

Photo Advice & Guidance launched in the NHS Coventry and Rugby CCG area nearly a year ago, with an aim to provide swift Advice & Guidance to community optometrists. Already the service has been used for over 100 patient cases, and 74% of these have resulted in the patient avoiding a referral/trip to hospital.

Ryan Desai is a part of the Optometry team at University Hospitals of Coventry and Warwickshire NHS Trust (UHCW). Ryan answers the Advice & Guidance requests from clinicians, community Optometrists and nurses via the Consultant Connect App. He has actively helped to achieve an average response time of just 4 hours. 

Dilesh Makwana, is a community Optometrist who uses Photo Advice & Guidance via the Consultant Connect App to request advice from Ryan and his colleagues. 

Read our interview with Dilesh and Ryan to find out more.


Ryan, how do you use Consultant Connect for Advice & Guidance in Secondary Care?

“I think the Consultant Connect App is a good tool for primary care to use for patients that may ordinarily have been sent through to eye casualty. There is often a doubt around the urgency of the condition i.e., if it needs immediate attention or can wait a few days. In such cases, Consultant Connect can come in very handy. Also, ambiguity around diagnosis or further treatment, say of a red eye or a swollen lid, can be swiftly resolved by sending a Photo Advice & Guidance message to me and my team members. We can quite comfortably offer advice in such cases and suggest the right pathway and next steps.”

Could you share any patient cases with us Ryan?

“I’ve had two or three Central serous retinopathy (CSRs) sent over on Optical Coherence Tomography (OCTs) where the optometrist was unsure of the best course of action i.e., whether the patients should be sent to the medical retina or is it a CSR. I was able to suggest the right pathway quite easily.”

Dilesh, does Consultant Connect help improve communication?

“Consultant Connect is a great way to communicate with the hospital. In the community, we usually don’t have the facility of obtaining a direct second opinion. However, with the Consultant Connect service, the expert opinion is available to you at a click of a button, with a very swift response time. It’s a great way to just get some added reassurance that we are doing the right thing.”

Have you got any patient cases that you could share with us Dilesh?

“There was a patient for whom I think the service worked really well. It was a 34-year-old male who had a corneal issue on one of his eyes, but because of his learning difficulties, he couldn’t quite communicate the discomfort he experienced. I took a photo and sent it over to the triage team at University Hospitals of Coventry and Warwickshire NHS Trust. I received a prompt response advising that it could be something that needed treatment straightaway. That patient was seen within 24 hours. My patients are aware of the service and have appreciated it.”

Dilesh, how would you describe the service for primary care? 

“To put it simply, it is an advice route to get a swift expert opinion on patient cases where there is doubt and uncertainty regarding further treatment, referrals, or correct pathway. It can also be seen as a training and a learning tool that we should really make the most of.

I personally find it really useful in the cases of unusual lumps and bumps, because for us such pathology cases are quite rare in practice, but the Optometry team at University Hospitals of Coventry and Warwickshire NHS Trust deals with such cases all the time in eye casualty or in ocular plastics and they can confidently give us guidance on whether or not such cases need referring.”

During the pandemic has this service has been particularly useful?


“Yes, I think it has been a brilliant support during the pandemic, especially now in the current situation, where patients are avoiding going to the hospital unless they absolutely have to, so if we’re able to communicate their case to the hospital, and seek advice remotely, it saves everyone the time and the money, and helps to expedite treatments. I think this is the way forward, even in post-pandemic period.”


“Yes, it has been a great Advice & Guidance tool, not only in keeping patients away from the eye unit but also in providing GPs with second opinions and re-assurances, especially in cases of children, and/or cases where treatment is being given over a long period of time and GPs need a re-confirmation regarding the suitability and continuity of the treatment. Consultant Connect has certainly proven useful during the COVID surge.”


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