Referral Pattern Changes Over a Decade in a Tertiary Neuro-Ophthalmology Clinic.
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PURPOSE: To evaluate changes in referral patterns, including referral sources, patient demographics, and diagnostic patterns to a neuro-ophthalmology unit in a single tertiary medical center across two distinct three-year periods, a decade apart. METHODS: A retrospective database analysis of patients seen for their initial visit in the NO Unit at a tertiary Medical Center in Israel during January 1st, 2007-December 31st, 2009 (Group 1-1436 patients), and during January 1st 2017-December 31st 2019 (Group 2-2104 patients). Data collected included patients' age, gender, referring provider specialty, primary complaint, clinical findings, and final diagnosis. RESULTS: Patients in Group 2 were significantly older than those in Group 1 (p < 0.024). There was a significant increase in referrals from ophthalmologists (p < 0.001) and pediatricians (p < 0.001), while referrals from neurologists (p < 0.006) and rehabilitation specialists (p < 0.003) declined, Diagnoses related to vision changes increased significantly over time (p <0.001). Diagnoses related to complaint of diplopia were more frequent in Group 2 (p < 0.01). A multinomial logistic regression further demonstrated that, after adjusting for age and sex, diagnoses of pseudotumor cerebri (PTC) (OR = 1.46, p = 0.004) and tumor/compressive lesions (OR = 1.55, p < 0.001) were significantly more likely in Group 2 compared with Group 1, whereas optic nerve disease, ocular motility disorders, and visual function complaints showed no significant temporal change. CONCLUSION: The study demonstrated an increase in referrals to NO services and a demographic shift toward older patient population. These findings emphasize the growing need for neuro-ophthalmologic expertise, particularly in the context of an aging population. Multinomial regression further showed that diagnoses of PTC and tumor/compressive lesions became significantly more common over the decade, highlighting evolving diagnostic trends that may inform resource allocation and future service planning.