{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T18:34:53Z","timestamp":1780684493852,"version":"3.54.1"},"reference-count":38,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Exper Ophthalmology"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients in rural Australia have limited access to intravitreal treatments due to a maldistribution of the ophthalmology workforce. To improve access, a novel outreach service model was implemented whereby junior medical staff administered intravitreal injections under a supervising ophthalmology consultant. This model involves outreach visits in hospitals, mobile clinics and a remote hub with intravitreal injections administered by junior doctors overseen by an ophthalmologist. The article explores the safety of this approach with respect to the rate of post\u2010injection endophthalmitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective audit was conducted by the Lions Outback Vision outreach ophthalmology service from 2017 to mid\u20102023. The number of injections, locations, diagnoses, intravitreal agents used, designation of administering doctor and cases of endophthalmitis were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A 12\u2009632 intravitreal injections were administered across 32 locations throughout rural Western Australia in the 6.5\u2010year period. Three cases of endophthalmitis occurred representing a rate of 0.0237%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The rate of endophthalmitis in the outreach service is comparable to other centres. The outreach model with supervising ophthalmology consultant support in person or via telehealth and administration of injections by junior medical staff has improved access for underserved or marginalised populations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ceo.14421","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T00:05:15Z","timestamp":1721952315000},"page":"853-860","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Endophthalmitis following intravitreal injections administered by junior medical officers in rural Western Australia"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7314-0384","authenticated-orcid":false,"given":"Jackson Chee Chea","family":"Lee","sequence":"first","affiliation":[{"name":"Lions Outback Vision, Centre for Ophthalmology and Visual Science University of Western Australia and the Lions Eye Institute  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2232-8731","authenticated-orcid":false,"given":"Hessom","family":"Razavi","sequence":"additional","affiliation":[{"name":"Lions Outback Vision, Centre for Ophthalmology and Visual Science University of Western Australia and the Lions Eye Institute  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5326-8412","authenticated-orcid":false,"given":"Marcel Maziyar","family":"Nejatian","sequence":"additional","affiliation":[{"name":"Lions Outback Vision, Centre for Ophthalmology and Visual Science University of Western Australia and the Lions Eye Institute  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5155-5469","authenticated-orcid":false,"given":"Jocelyn","family":"Drinkwater","sequence":"additional","affiliation":[{"name":"Lions Outback Vision, Centre for Ophthalmology and Visual Science University of Western Australia and the Lions Eye Institute  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5949-7451","authenticated-orcid":false,"given":"Angus Warwick","family":"Turner","sequence":"additional","affiliation":[{"name":"Lions Outback Vision, Centre for Ophthalmology and Visual Science University of Western Australia and the Lions Eye Institute  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2008.10.018"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2010.03.045"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2016.02.022"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2010.02.021"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2013.08.012"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12886\u2010021\u201002231\u20108"},{"key":"e_1_2_8_8_1","first-page":"48","volume-title":"Ophthalmology\u2014Australia's Future Health Workforce Report","author":"Department of Health","year":"2018"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.835804"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19148593"},{"key":"e_1_2_8_11_1","unstructured":"RANZCO.Advocating for rural regional and remote patients [Press release].2021.https:\/\/mcusercontent.com\/0412f950aa96d1122aaf84b86\/files\/d21a417b\u2010fba5\u2010416a\u2010e222\u20103e41fe7329a5\/Media_release_3.12.2021_rural_regional_and_remote.pdf"},{"key":"e_1_2_8_12_1","unstructured":"RANZCO.Regional and remote RANZCO: RANZCO [updated 20 April 2020; cited 2023 8 October 2023].2020https:\/\/ranzco.edu\/home\/community-engagement\/regional-and-remote\/"},{"key":"#cr-split#-e_1_2_8_13_1.1","unstructured":"RANZCO.RANZCO Strategic plan 2021-2023 [8 October 2020"},{"key":"#cr-split#-e_1_2_8_13_1.2","unstructured":"cited 2023 8 October 2023].2023https:\/\/ranzco.edu\/wp\u2010content\/uploads\/2020\/10\/RANZCO\u2010Strategic\u2010plan\u20102021_2023\u2010FINAL.pdf"},{"key":"e_1_2_8_14_1","unstructured":"Macular Disease Foundation Australia and PwC Australia.Saving sight saves money: Addressing treatment access and affordability in macular disease. Full Report.2024.6_MDFA\u2009Saving\u2009Sight\u2009Saves\u2009Money\u2009report\u2010\u2009February\u20092024\u2009(1).pdf\u2009(pubmate.in)"},{"key":"e_1_2_8_15_1","unstructured":"Australian Bureau of Statistics.Western Australia\u2014Wheat belt: 2021 Census all persons quickstats.2021https:\/\/www.abs.gov.au\/census\/find-census-data\/quickstats\/2021\/509"},{"key":"e_1_2_8_16_1","unstructured":"Australian Bureau of Statistics.Western Australia\u2014Outback (North): 2021 census all persons quickstats.2021https:\/\/www.abs.gov.au\/census\/find-census-data\/quickstats\/2021\/510"},{"key":"e_1_2_8_17_1","unstructured":"Australian Bureau of Statistics.Western Australia\u2014Outback (South): 2021 census all persons quickstats.2021https:\/\/www.abs.gov.au\/census\/find-census-data\/quickstats\/2021\/511"},{"key":"e_1_2_8_18_1","unstructured":"Australian Bureau of Statistics.Greater geraldton: 2021 census all persons quickstats.2021https:\/\/www.abs.gov.au\/census\/find-census-data\/quickstats\/2021\/LGA53800"},{"key":"e_1_2_8_19_1","unstructured":"Australian Bureau of Statistics.Carnavon. Census all persons quickstats.2021https:\/\/www.abs.gov.au\/census\/find-census-data\/quickstats\/2021\/LGA51540"},{"key":"e_1_2_8_20_1","unstructured":"Area of Australia\u2014States and Territories.Commonwealth of Australia (Geoscience Australia) [cited 8 October 2023] [Internet].2023https:\/\/www.ga.gov.au\/scientific-topics\/national-location-information\/dimensions\/area-of-australia-states-and-territories"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/ceo.13522"},{"key":"e_1_2_8_22_1","unstructured":"Medical Board of Australia.General registration.2018https:\/\/www.medicalboard.gov.au\/Registration\/Types\/General-Registration.aspx"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/ceo.12026"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oret.2020.11.008"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/aos.12981"},{"key":"e_1_2_8_26_1","unstructured":"International Organization for Standardization.ISO 80369\u20107:2021 Small\u2010bore connectors for liquids and gases in healthcare applications.2021https:\/\/www.iso.org\/standard\/79173.html"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2013.08.037"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics14102133"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-79377-w"},{"issue":"4","key":"e_1_2_8_30_1","first-page":"559","article-title":"Incidence of endophthalmitis after intravitreal injections: risk factors, microbiology profile, and clinical outcomes","volume":"26","author":"Mishra C","year":"2018","journal-title":"Ocul Immunol Inflamm"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajr.12348"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2014.69"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41433-020-0920-2"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.3928\/23258160-20150610-08"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2015.04.013"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa054481"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2013.107"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41433-021-01646-3"}],"container-title":["Clinical &amp; Experimental Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ceo.14421","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T01:25:29Z","timestamp":1731374729000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ceo.14421"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,25]]},"references-count":38,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1111\/ceo.14421"],"URL":"https:\/\/doi.org\/10.1111\/ceo.14421","archive":["Portico"],"relation":{},"ISSN":["1442-6404","1442-9071"],"issn-type":[{"value":"1442-6404","type":"print"},{"value":"1442-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,25]]},"assertion":[{"value":"2024-04-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}