RCOphth Annual Congress 2026

Performance and Safety of a Virtual Vitreoretinal Surgical Triage Pathway: A Retrospective Audit of 154 Patients

Authors: Alexander Fraser¹, Riddhi Thaker¹, Aman Chandra¹, Beatrice Gallo¹

Affiliation: ¹ Southend University Hospital, Mid and South Essex NHS Foundation Trust, United Kingdom

Introduction:

Virtual triage models are established in medical retina and glaucoma.¹ Vitreoretinal surgery relies on high-risk diagnostic decision-making, yet despite the potential for patient and service level benefit,^2-3 virtual triage pathways in this context remain under-evaluated. We evaluated the performance of a virtual vitreoretinal clinic (VVRC) newly implemented at Southend University Hospital.

Methods:

Retrospective audit of a consultant-led VVRC (Mar–Sep 2025)

Patients attended an imaging hub (VA, autorefraction, OCT, widefield imaging) with a standardised symptom questionnaire

Cases were reviewed remotely by a vitreoretinal surgeon, with direct patient contact for counselling or surgical consent

Outcomes included triage category, face-to-face (F2F) escalation reasons, surgical listing, and time intervals

Results:

154 patients (191 eyes), mean age 70.4 years

Virtual triage outcomes (Figure 1) show 61.6% reduction in hospital footfall

Discharged (27.9%)

Virtual followup (17.5%)

Surgical listing (15.6%)

Rebooked to another clinic (11.7%)

Indications for virtual clinic surgery listing (Figure 2)

Reasons for F2F escalation (Figure 3) shows only minority unavoidable

Inappropriate for virtual as peripheral exam necessary (29.1%)

High complexity discussion and decision (12.7%)

Flow chart of pathway from virtual referral to surgery (Figure 4)

Notably detected previously undiagnosed retinal detachments and tears

Conclusion:

Majority avoided F2F review, reducing clinic burden

Surgeries listed directly from virtual review

Imaging safely identified unexpected sight-threatening pathology (RD, HST)

Most F2F escalations were avoidable system issues

VVRC is a safe, scalable NHS triage model

“61.6% of referrals avoided need for in-person review showing virtual triage can safely reduce NHS burden”

References:

1. Otti V, Kang S, Keane PA. Virtual eye clinics in the United Kingdom - pros and cons. Expert Rev Ophthalmol. 2025;20(5):223-226. doi:10.1080/17469899.2025.2550691

2. Yang E, Rees A, Ahadzi S, et al. Virtual vitreoretinal clinics: a service delivery pathway of the future. Int J Retina Vitreous. 2025;11(1). doi:10.1186/S40942-025-00684-3

3. Anguita R, Ahmed S, Makuloluwa A, Hind J, Roth J, Wickham L. Prospective validation of a virtual post-operative clinic in vitreoretinal surgery. Eye (Lond). 2024;38(17):3258-3262. doi:10.1038/S41433-024-03272-1

Link to Practice Preference Survey: https://forms.gle/AZw6HUXbjxpcw7gG7

RCOphth Annual Congress 2026

Performance and Safety of a Virtual Vitreoretinal Surgical Triage Pathway: A Retrospective Audit of 154 Patients

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