Abstract Aim: To evaluate the concordance between diagnoses provided by trained vision center(VC) technician and neuro-ophthalmologists for patients referred from VC to the Neuro-Ophthalmology Clinic. Methodology: This retrospective observational study analyzed electronic medical records (EMR) from the neuro-ophthalmology outpatient department for 1 year. The investigation involved a comprehensive review and comparison of findings between trained VC technicians and neuro-ophthalmologist. Collected data included patient age, sex, clinical history, time from referral to hospital arrival, and the final diagnosis. Results: The study incorporated data from 17 VC facilities, encompassing 331 referrals, with a mean age of 45 years (range: 7–83 years). The overall agreement between diagnoses made by trained VC technicians and neuro-ophthalmologist was 66%. This agreement was sustained in 66% of cases (195 out of 297) for afferent pathway disorders and in 67% of cases (24 out of 36) for efferent pathway disorders. Specific clinical findings showed varying levels of alignment between the VC and neuro-ophthalmologist assessments: lid abnormalities achieved the highest agreement at 89% (κ = 0.75), while pupil abnormalities had the lowest at 48% (κ = 0.40). The overall kappa coefficient was 0.66 (95% confidence interval: 0.60–0.72), indicating substantial agreement ( P < 0.001), with specialist evaluations. Conclusion: The findings underscore the diagnostic capabilities of trained VC technicians, with substantial diagnostic concordance between trained VC technician and neuro-ophthalmology specialist.
Balraj et al. (Thu,) studied this question.