搜索结果：Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

Neurofibromatosis-type 1 (NF1) is a genetic disorder characterized by developing optic pathway gliomas (OPGs) in 15%-20% of patients with higher estimates where consanguinity is prevalent. Clinically, NF1-OPG might be unpredictable with the risk of OPG progression and visual impairment. The optimal time for screening is controversial. We aim to identify the mean/median age at diagnosis of NF1-OPG and its clinical spectrum. A systematic review of PubMed, Web of Science, and Embase databases was conducted for English-language publications from January 1993 to October 2025, exploring the visual screening of OPGs in NF1 patients, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered in the Prospective Register of Systematic Reviews (PROSPERO ID: CRD420251036244). Inclusion criteria focused on studies reporting the age at OPG diagnosis and visual manifestations in NF1 patients. Data were extracted on demographics, age at NF1 and OPG diagnosis, tumour location (using the Dodge classification), and presenting symptoms. Sixteen studies met the inclusion criteria. Among 4 739 NF1 patients, 818 had OPGs, with prevalence ranging from 4.2% to 46.7%. The age at NF1 diagnosis ranged from 0 to 132 months (mean: 18-38 months), and at OPG diagnosis from 0-240 months (median: 29-58 months). Approximately 58.4% of OPGs were asymptomatic, and 25% were above the age of 5 years. Among symptomatic patients, the most frequent presentations included decreased visual acuity (62%), abnormal optic disc (45%), proptosis (20%), strabismus (12%), and visual field defects (7%). NF1-related OPGs typically present early within 6 years of age. Early ophthalmologic and/or radiologic screening at the time of NF1 diagnosis enhances the detection of silent OPGs.

Actinic Keratosis (AK) is a precancerous lesion related to radiation exposure, leading to malignant transformation (MT). This study aims to assess the epidemiological, clinical and histopathological features of AK in the eyelid to allow early diagnosis and treatment. The McGill University Ocular Pathology & Translational Research Laboratory studied 200 biopsied lesions from 192 patients with a final diagnosis of AK amidst 1993 and 2023. Out of the total, 16 patients and 17 lesions were excluded due to insufficient data about the lesion's location. Samples from 176 patients (183 lesions) were analyzed. The mean age of diagnosis for eyelid AK (EAK) was 73 years old. The co-occurrence of AK and squamous neoplasia within the same specimen was 18.6% for EAK. The typical histopathological variant was the more prevalent representing 53% of all EAK lesions. The most common lesion site in the eyelid was the lower eyelid, constituting for 52.2%. To the best of our knowledge, this is the largest series of patients with EAK. This study emphasizes the importance of early excision with safety margins as a primary choice of treatment due to the risk of co-occurrence of AK and squamous neoplasia.

Optic neuritis is often managed by neuro-ophthalmologists. Neuro-imaging plays an important role in diagnosis. Radiologists can influence care by communicating pertinent findings and recommending next steps. Increasingly, patients have direct access to their reports, which may affect their understanding, anxiety, and interactions with clinicians. This study aimed to characterize the frequency and nature of radiologists' recommendations in magnetic resonance imaging (MRI) reports for optic neuritis. A retrospective chart review. Patients referred to a tertiary neuro-ophthalmology clinic between November 2007 and May 2025 with new-onset optic neuritis and no prior demyelinating disease METHODS: Data on imaging protocols, diagnostic terminology, differential diagnoses, recommendations, and incidental findings were obtained from electronic medical records. We included 219 MRI reports (73.1% female; mean age: 37.4 ± 13.1 years). MRI of the brain and orbit was the most common protocol (73.5%). Signs of demyelination or possible demyelination were noted in 109 cases (49.8%). Overall, recommendations were provided in 16.0% (35/219) to patients, with 20.2% (22/109) of those showing demyelination compared with 2.7% (3/110) without demyelination. The top 3 recommendations were an MRI of the spine (17/22; 77.3%), follow-up imaging (2/22; 9.1%), and follow-up appointment with patient and MRI of orbit (1/22; 4.5% each). Among participating radiologists, recommendations were given to patients in a minority of optic neuritis cases, with MRI of the spine being the most common recommendation. There was a higher likelihood of a recommendation if there were brain changes (20%) compared with no brain changes (3%). These findings highlight variability in reporting practices and support the adoption of standardized language for describing optic nerve abnormalities and appropriate follow-up, reducing unnecessary testing and potential patient anxiety.

Full-thickness skin grafts (FTSG) are a commonly used tool in facial reconstruction. The success of a skin graft is paramount to the structural integrity of a defect repair. We sought to systematically review existing evidence for factors influencing the success of full-thickness skin grafts in the periocular region. A systematic review of published literature from 1965 to December 1, 2025, was conducted following PRISMA guidelines. Publication descriptors, methodological details, and overall results were extracted. Articles were assessed for methodological quality using MINORS, Cochrane ROB 2, or AMSTAR 2 instruments depending on study type. Twenty-six studies were included. Most were retrospective, and 73.1% were from the 3rd level of evidence. Noncomparative, nonrandomized studies were generally rated as higher quality, with the remainder being low to moderate. Nine studies reported graft failure, with an incidence below 10% in nearly all studies. The only comparative study that found a statistically significant decrease in graft survivability was with infiltration of lidocaine with epinephrine into the graft donor site compared with infiltration of lidocaine without epinephrine (p = .05). Overall, studies investigating factors influencing FTSG were of low to moderate quality. Success of FTSG in the periocular region was high regardless of additional interventions. Local anesthetic use with epinephrine was, however, associated with worse outcomes. Our review identified a need for additional high-quality evidence that can be used to indicate whether the donor site affects success for this intervention, as well as additional randomized controlled trials to improve the quality of the literature.

Selective laser trabeculoplasty (SLT) has increasingly been used as a first-line glaucoma treatment. To better understand its impact on the Canadian patient and health care system, a cost-effectiveness analysis was performed to compare SLT against topical eye medications for patients with newly diagnosed open-angle glaucoma. Using a Markov model with a 20-year horizon from a health care payer perspective, the incremental cost-effectiveness ratio (ICER) of treating newly diagnosed mild open-angle glaucoma with SLT and medication was calculated. A discount rate of 1.5% was applied to all costs and health outcomes. Sensitivity and probabilistic analyses were performed to test the uncertainty of the model. The base case analysis indicated that patients who received the SLT treatment had a lower health care system cost of $1,671.48 and a higher quality-adjusted life year of 0.09 per patient compared with the medication treatment. As a result, the SLT treatment dominates medication treatment. The one-way cost-effectiveness sensitivity analysis showed that SLT dominates the medication treatment at all discount rates between 0% and 3%. The largest effects on the ICER value were variations in medication utility of ocular hypertension and mild glaucoma state, and SLT utility of mild glaucoma state, based on the tornado diagram. Probabilistic sensitivity analyses also demonstrated that the SLT treatment dominated the medication treatment. Our model suggests that SLT as the initial treatment strategy for glaucoma patients and investment in SLT could lead to improved clinical outcomes, costs, and resource utilization within the Canadian health care system.

To evaluate treatment patterns of newly diagnosed glaucoma among patients with uveitis compared with primary open-angle glaucoma (POAG) without uveitis, and to identify predictors of surgical intervention. Retrospective cohort study using a multicentre electronic health record network. Adults ≥40 years with glaucoma were identified using ICD-10 codes and stratified by uveitis history within a 2-year lookback. Two phenotypes for uveitis-associated glaucoma were evaluated: (i) specific (uveitic or steroid-induced glaucoma) and (ii) sensitive (including POAG with uveitis). Cohorts were propensity score-matched (1:1) to POAG controls without uveitis. Outcomes included incidence of bleb-forming glaucoma surgeries (trabeculectomy, aqueous shunts, XEN stents), non-bleb-forming procedures (minimally invasive glaucoma surgeries, selective laser trabeculoplasty), and initiation of intraocular pressure (IOP)-lowering drops over 10 years. Cox models estimated hazard ratios (HRs) with 95% CIs. In the specific phenotype (n = 7848 per cohort), uveitis-associated glaucoma was associated with greater risk of bleb-forming surgery (8.9% vs 4.1%; HR: 1.75 [95% CI: 1.56-1.96]), particularly aqueous shunts (HR: 2.95 [95% CI: 2.55-3.42]); trabeculectomy risk was lower (HR: 0.70 [95% CI: 95% 0.54-0.91]). In the sensitive phenotype (n = 13 873 each), uveitis history was associated with greater risk of bleb-forming surgery (HR: 1.76 [95% CI: 1.60-1.93]), including aqueous shunts (HR: 2.67 [95% CI: 2.38-3.00]), but lower risk of noninvasive procedures and IOP-lowering drops. Predictors of bleb-forming surgery included male sex, Hispanic ethnicity, anterior uveitis, nicotine dependence, higher body mass index, and immunomodulatory therapy use. Uveitis-associated glaucoma is associated with a greater risk of bleb-forming surgery, especially aqueous shunts, highlighting the need for early identification and tailored management in this high-risk population.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for diabetes, obesity, and cardiovascular risk reduction. However, their ocular safety profile, particularly regarding age-related macular degeneration (AMD), remains uncertain. This systematic review evaluates the association between GLP-1 RA use and the incidence or progression of AMD including both nonexudative and neovascular subtypes. A systematic review was conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and registered with PROSPERO (CRD420251183938). MEDLINE, Embase, CENTRAL, Web of Science, and PubMed were searched from inception through 2025 for observational studies and randomized trials evaluating AMD outcomes among adults exposed to GLP-1 RAs. Comparators included nonuse, placebo, or alternative metabolic therapies. Risk of bias was assessed using Risk of Bias in Non-Randomized Studies of Interventions and certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation framework. Due to heterogeneity of outcome definitions, results were synthesized qualitatively. Eight observational studies encompassing 91 408 to 600 816 participants were included. GLP-1 RA use was associated with a reduced incidence of nonexudative AMD across diabetic and nondiabetic populations, with relative risk reductions varying substantially by population, comparator, and follow-up duration. Findings for neovascular AMD were heterogeneous: most studies reported neutral or protective associations, whereas one population-based cohort of older adults with diabetes observed an increased risk (adjusted hazard ratio 2.21, 95% CI 1.65-2.96), with low absolute event rates. Overall risk of bias was moderate to high, and certainty of evidence for all outcomes was very low. Current evidence does not demonstrate a consistent increase in AMD risk associated with GLP-1 RA therapy and may be associated with a lower incidence of nonexudative AMD, although the certainty of evidence is very low and noncausal explanations cannot be excluded. Prospective studies with standardized endpoints are needed to clarify causal relationships.

To assess long-term functional and structural outcomes in eyes treated with laser photocoagulation for retinopathy of prematurity (ROP). Patients treated for ROP (1997-2004) underwent best-corrected visual acuity (BCVA) assessment, autorefraction, biometry, OCT, and OCT angiography of the macula and optic disc. Patient characteristics were retrieved from neonatal medical records. Sixty-three eyes of 33 patients with a mean follow-up of 19 years, and 22 eyes of 11 age-matched controls were included. The laser-treated group had a mean BCVA of 0.133 (&#xb1;0.17) logMAR. Poor anatomical outcome occurred in 6.3% (n&#x202f;=&#x202f;4), with 2 eyes requiring surgery. Mean spherical equivalent was -5.04 (&#xb1;5.13) D. Corneal curvature and lens thickness were significantly higher in the study group (p < .001). Central macular thickness was greater in ROP eyes (311.97 &#x3bc;m vs 252.57 &#x3bc;m; p < .001). Vascular density was increased in the foveal region and decreased in other regions (p < .001), and the foveal avascular zone was smaller (p < .001). Optic disc analysis showed a reduction in cup-to-disc ratios and peripapillary capillary density (p < .001). Two decades after laser treatment, our patients demonstrated excellent visual acuity and favourable anatomic outcomes. Myopia was linked to increased corneal curvature and lens thickness. Significant alterations in the vascular plexuses of the macula and optic disc occur and may impact visual function in adulthood.

To review the effectiveness of selective laser trabeculoplasty (SLT) for steroid-induced glaucoma and steroid-induced ocular hypertension. Steroid-induced glaucoma and ocular hypertension often occur in medically complex eyes that may require continued corticosteroid therapy. SLT may provide intraocular pressure control while reducing dependence on topical glaucoma medications. This systematic review was registered with PROSPERO (CRD420251274498) and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (or PRISMA) guidelines. Ovid MEDLINE, Embase, and the Cochrane Library were searched from inception to December 28, 2025. Eligible studies included patients with steroid-induced glaucoma or ocular hypertension treated with SLT and reporting intraocular pressure outcomes. Two reviewers independently performed screening, full-text review, data extraction, and Risk Of Bias In Non-randomized Studies of Interventions-I (or ROBINS-I) risk-of-bias assessment. Because of heterogeneity in design, follow-up, and outcome reporting, results were synthesized descriptively. Nine studies comprising 162 eyes were included. Most were retrospective, with sample sizes ranging from 4 to 35 eyes and follow-up from 1 to 24 months. Baseline intraocular pressure ranged from 21.7 &#xb1; 0.9 to 38.4 &#xb1; 7.3 mm Hg, and final intraocular pressure ranged from 13.3 to 16.1 &#xb1; 3.4 mm Hg. Reported intraocular pressure reduction ranged from 27.7% to 59.1%, with sustained effects beyond 12 months in several studies. Seven studies reported a reduced glaucoma medication burden after treatment. No major sight-threatening adverse events were identified. Risk of bias was moderate to serious in most studies. SLT appears to be a promising and generally safe option for steroid-induced glaucoma and ocular hypertension, but higher-quality prospective comparative studies are needed.

Inherited optic neuropathies (IONs) cause progressive visual loss and substantially affect quality of life. This updated systematic review aims to synthesize and evaluate evidence on the patient experience of living with IONs, identify currently used assessment tools, and highlight areas for improvement in research and clinical care. We systematically searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Scopus for studies on (i) inherited optic neuropathies; (ii) quality of life or health status; (iii) patient-reported outcome measures; and/or (iv) qualitative research. Inclusion was restricted to peer-reviewed studies. Screening, data extraction, and risk of bias assessment were conducted using Covidence. From 1775 unique records, 5 studies met the inclusion criteria. They evaluated quality-of-life outcomes in patients with Leber hereditary optic neuropathy or autosomal-dominant optic neuropathy across 6 countries. Patient-reported outcome measures used included National Eye Institute Visual Functioning Questionnaire-39, National Eye Institute Visual Functioning Questionnaire-25, Short-Form 12 Health Survey, Beck Depression Inventory, and Pittsburgh Sleep Quality Index. Only one study used qualitative interviews to explore the emotional, social, and financial impacts on patients and families. This updated systematic review builds upon previous work to further characterize the impact of ION on patients living with these conditions and the tools currently used to assess them. We highlight the need for a multifaceted approach to ION management, combining medical treatment with comprehensive psychosocial support to work toward more patient-centred care and improved quality of life for those living with these challenging conditions.

Bupivacaine is the most cardiotoxic local anesthetic. We present a case of a healthy 63-year-old female with no history of arrhythmias, ischemia, or other cardiac disease who had a cardiac arrest caused by bupivacaine during a blepharoplasty. A 63-year-old healthy female with no history of arrhythmias, ischemia or other cardiac disease presented for an upper and lower blepharoplasty. Intraoperatively a total of 12 ccs of 1:1 lidocaine 2% with 1:100,000 epinephrine and bupivacaine 0.50% with 1:100,000 epinephrine was given subcutaneously and subconjunctivally in the lower eyelids. The patient developed ventricular tachycardia progressing to asystole 5 minutes after the injections. Cardiopulmonary resuscitation led to a return of circulation. Extensive investigations, including consultations with cardiologists and electrophysiologists, ruled out underlying cardiac pathology, and the cardiac arrest was determined to result from bupivacaine cardiotoxicity. This case highlights the potential for cardiac complications from the local administration of bupivacaine. It emphasizes the need for cardiac monitoring and the resources for cardiopulmonary resuscitation when using bupivacaine in periorbital anesthesia.

This study aimed to validate administrative data case definitions for identifying individuals with uveitis within health administrative data and to assess case definition performance in different age groups. Among 200,386 eligible patients in a large, province-wide, multisite primary care electronic medical record data repository in Ontario, Canada, 1 020 individuals were selected for medical review based on uveitis-related search terms. After medical record review, 431 cases were identified as having uveitis, in addition to 10,000 nonuveitis cases, which were used to make up the validation reference sample. After the reference standard was linked with administrative data, the performance characteristics (sensitivity and positive predictive value [PPV]) of case definitions using combinations of data sources and time windows were assessed overall, and stratified by age groups. Within the validation sample, the median age of identified uveitis patients was 55 years, with the majority falling within the 26-64 age group. Females represented 59.9% of cases. Family physicians (72.2%) and ophthalmologists (60.6%) were the most common sources of diagnosis documentation, and anterior uveitis was the most prevalent classification (64.0%). At least 1 diagnosis code for uveitis had the highest sensitivity at 74.0% (95% CI: 69.9-78.2) with a PPV of 54.3% (95% CI: 50.2-58.3). PPV increased with more physician diagnosis codes but was accompanied by decreased sensitivity. Case definitions demonstrated variations in sensitivity and PPV across different age groups. This study identified administrative data case definitions for identifying uveitis, with varying sensitivity and PPV for a range of research purposes and data availability.

To estimate the pooled prevalence, anatomical distribution, and occupational impact of work-related musculoskeletal (MSK) pain among ophthalmologists, and to identify modifiable ergonomic risk factors. A systematic review and meta-analysis of published data. The protocol was preregistered (PROSPERO CRD42023422368) and reported in accordance with PRISMA. The participants were 6691 ophthalmologists from 21 studies. Electronic databases (MEDLINE, Embase, Cochrane, and PubMed) were searched for peer-reviewed quantitative studies reporting MSK pain prevalence in ophthalmologists. Pooled estimates with 95% CI were calculated using random-effects models; heterogeneity was quantified using I&#xb2;. Prevalence of overall and site-specific MSK pain; effects on workload and productivity; prevalence of treatment or mitigation strategies. The pooled prevalence of any MSK pain was 70% (95% CI: 65%-75%; I&#xb2;&#x202f;=&#x202f;92%); neck (41%; 95% CI: 35%-47%; I&#xb2;&#x202f;=&#x202f;95%), lower back (36%; 95% CI: 32%-39%; I&#xb2;&#x202f;=&#x202f;87%), and shoulder pain (28%; 95% CI: 22%-35%; I&#xb2;&#x202f;=&#x202f;91%) were most common. Pain led to workload modification in up to 44% and contributed to reduced clinical volume, sick leave, or contemplation of early retirement. Forty-six percent (95% CI: 22%-71%) pursued no treatment; 39% (95% CI: 30%-49%) used medical therapy; and 29% (95% CI: 20%-41%) sought physiotherapy. Heterogeneity was high across studies, reflecting differing case definitions and self-reported measures. MSK pain affects most ophthalmologists, particularly in the cervical and lumbar regions and frequently alters practice patterns. These findings underscore the need for early ergonomic training, structured micro-breaks, and workspace redesign. Prospective intervention trials are required to establish causality and quantify benefit.

To identify clinical and radiological features to better predict surgical intervention in pediatric orbital cellulitis (OC). A retrospective study, including pediatric patients who had clinico-radiological evidence of bacterial orbital cellulitis. Patient demographics, orbital imaging, presence of orbital or subperiosteal abscesses (SPA), surgical and/or medical management, and outcomes were noted. Statistical analysis was conducted using independent samples t test and &#x3c7;2 tests with significance defined as p < 0.05. Eighty-seven patients were diagnosed with OC between 2012 and 2024 (mean age 8.66 &#xb1; 4.34 years; range: 0.04-17 years). Surgical intervention was required in 59.8% (52/87). Associations were found with proptosis (p < .001), restricted ocular motility (p < .001), optic neuropathy (p&#x202f;=&#x202f;.037), orbital/SPA abscess (p < .001), and inflammatory markers (white cell count: p&#x202f;=&#x202f;.021; C-reactive protein: p&#x202f;=&#x202f;.047). The most common SPA location was medial (43/53, 81.1%), which was significantly associated with surgery (p < .001). In surgical cases, greater periosteal elevation of 6.0 &#xb1; 3.2 mm and anterior-posterior (AP) abscess length of 22.5 &#xb1; 8.1 mm was observed (p&#x202f;=&#x202f;.047 and p&#x202f;=&#x202f;.013, respectively). Mean time to surgery was 23.6 &#xb1; 20.7 hours (range: 1.6-92.7 hours), with 67.3% occurring within 24 hours. Surgical cases had longer hospital stays (7.82 vs 4.74 days; p < .001). Complete resolution occurred in 92.0% (80/87) of patients. Proptosis, impaired ocular motility, and radiological evidence of abscess were found to be associated with surgical intervention in pediatric OC. Additionally, patients with a SPA surgery were more likely to have greater periosteal elevation and AP abscess length. Surgical intervention was found to be higher in this cohort than that documented in other literature.

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To describe the national epidemiology, injury patterns, and temporal trends of sports-related retinal injuries presenting to U.S. emergency departments. Retrospective, cross-sectional study. Patients presenting to U.S. emergency departments with sports-related retinal injuries recorded in the National Electronic Injury Surveillance System from 2005 through 2024. National Electronic Injury Surveillance System records involving ocular injuries were screened for confirmed retinal pathology, defined as traumatic involvement of the neurosensory retina or retinal vasculature. National estimates were calculated using survey weights to account for the complex sampling design. Temporal trends were evaluated using survey-weighted annual estimates and Spearman's rank correlation. A total of 335 unweighted cases were identified, representing approximately 9787 cases nationwide. The mean age was 30.4 &#xb1; 19.7 years, and 70.2% of injuries occurred in male patients. Adolescents aged 10-19 years represented the largest affected group (41.8%). Retinal detachment (19.5%), vitreous hemorrhage (18.9%), and commotio retinae (13.5%) were the most common diagnoses. Soccer was most frequently implicated (25.2%), followed by gas-, air-, or spring-operated guns (8.4%) and basketball (7.1%). Both the annual national frequency (&#x3c1;&#x202f;=&#x202f;0.711; P < 0.001) and proportion relative to total sports-related ocular trauma (&#x3c1;&#x202f;=&#x202f;0.857; P < 0.001) increased significantly from 2005 to 2024. Sports-related retinal injuries remain uncommon but have increased significantly over time, particularly among adolescents. Ball sports and activities that involve projectiles account for most cases, with retinal detachment and vitreous hemorrhage representing the most frequent pathologies. These findings highlight the growing burden of retinal injury, underscoring the need for targeted prevention and improved detection in acute care settings.

To compare the clinical and sociodemographic characteristics of limited and persistent uveitis cases and temporal trends in incidence in Ontario. A retrospective population-based study using Ontario health administrative data identifying individuals with limited or persistent uveitis. The analysis described demographics, comorbidities, aggregated diagnosis groups (ADGs), resource utilization, income quintiles, and systemic therapy use. Annual age/sex-standardized, and age-specific incidence rates of limited and persistent uveitis were determined. Between 2000 and 2023, 289 031 limited and 41 482 persistent uveitis cases were identified, with mean index ages of 56.8 (SD 21.0) and 58.3 (SD 20.3) years, respectively. A higher proportion of children and youth were identified with limited duration uveitis. Sex distribution was similar between groups, and 89%-91% of cases resided in urban areas. Persistent uveitis cases had significantly more moderate to high ADGs (86.0%) compared with limited cases (16.2%), with hypertension being the most prevalent comorbidity in both limited (43.8%) and persistent (46.4%) uveitis cases. Persistent cases also had substantially higher resource utilization than limited uveitis cases. Incidence rates were higher for limited uveitis overall and among older age groups. Annual age-specific incidence declined in older age groups but increased over time for children with limited duration uveitis. This study highlights significant age-related trends in uveitis incidence, including an increase in pediatric cases and a high incidence of uveitis among the elderly. Age-specific health care strategies and resource planning are essential for adapting interventions and ensuring timely access to care.

To assess the completeness of glaucoma referral documentation and identify omitted clinical information in referrals to glaucoma specialists. A retrospective chart review. Referrals submitted by optometrists and ophthalmologists to 2 glaucoma specialists between January and December 2024. Optometry and ophthalmology glaucoma referrals were retrospectively reviewed and evaluated for documentation completeness. The total completeness score and proportion of missing elements were compared between referral sources. Multivariable analyses were performed to assess the association between referral completeness and intervention at first visit, as well as wait time. A total of 522 referrals were analyzed, including 336 from optometrists and 186 from ophthalmologists. Optometry referrals were more complete than ophthalmology referrals (median 9 [IQR: 7-10] vs 5 [IQR: 4-6]; p < .001). Visual field testing and optical coherence tomography were among the most frequently omitted elements in both groups. Ophthalmology referrals more often lacked systemic history and systemic medication documentation, whereas optometry referrals more often omitted ocular history and ocular medications. Intervention at first visit occurred more frequently in ophthalmology referrals than optometry referrals (59.7% vs 33.9%; p < .001), corresponding to 1.68 referrals required to result in 1 intervention compared with 2.95 in optometry. Glaucoma referral completeness differs significantly by referral source. Optometry referrals were more complete than ophthalmology referrals; however, both groups demonstrated gaps that may impact clinical assessment. These findings support the need for standardized guidelines to improve referral quality and optimize patient care.