The prevalence of AMD increased 18% between 2000 and 2010 and is expected to double by 2050, according to the NEI. Thus, as the primary eye care providers, O.D.s will encounter more of these patients and diagnose AMD earlier with the many advances in treatment, the continued evolution of research and emerging technologies. This means that the timely referral of AMD patients to the appropriate sub-specialists (retinal specialists) is more important than ever for both the patient’s vision and the doctor to protect himself from a malpractice lawsuit.

Accurately diagnosing a patient with AMD is the first step in the referral process. However, to fully protect the patient from vision loss and ourselves from malpractice lawsuits, we must diagnose and refer the patient, as well as have an effective referral process. This consists of properly educating the patient on the referral; referring to a competent physician; creating and maintaining good communication with said physician; and establishing office procedures that ensure the referral is made and the patient is followed at the necessary intervals. While all three components are important, patient education is the key factor of an effective referral process.


This is more than handing a patient the card of the retinal specialist and telling him the appointment date and time. The patient must understand the importance of the referral and the risk of harm if he does not follow through. Depending on the jurisdiction, a patient’s malpractice case is strengthened if he can show the O.D. did not stress the importance of the referral or presented the referral as an option. Often, this may be the patient’s word against the O.D.’s. Sans documentation, it is difficult to prove the referral was done and done properly.

To protect yourself, consider implementing a patient education procedure. For example, instead of giving the patient a card or a single referral sheet, give him a document that explains AMD, the need for the referral and any risks associated with not going to the referral appointment. Then, have the patient sign the document and scan it into the patient’s chart. There’s your documentation!