Primary care Eye Examination Rotterdam

Successful substitution of care

The long access time to secondary ophthalmic care is an eyesore for patients and doctors. In the Rotterdam pilot project ‘Primary care Eye Examination’, patients are referred to specialised optometrists at Star-shl for non-acute ophthalmic diagnostic testing. This produced surprising results in the first year of the project. For almost 80% of the patients, no referral to secondary care was necessary.

In 2019, Star-shl started offering eye examinations carried out by an optometrist with extensive clinical experience. The ophthalmologists from participating hospitals ensure quality assurance. In 2020, we made an ophthalmology e-learning module (primary care) available to all general practitioners and a third refresher course took place.

At the Medical Diagnostic Centre at Rotterdam Blaak, several surgery hours are held weekly. The access time is less than 2 weeks.

Satisfied patients and GPs

In the meantime, more than 1,200 patients have visited the surgery hours. Patients and general practitioners are positive about the optometrist’s accessibility, treatment, information and feedback.

“A large proportion of the more than 1,200 patients require no further treatment (44%) or can be monitored in primary care by an optician or GP,” says Hanne Buizer-Rijksen, staff doctor at Star-shl. “In only 22% of patients the optometrist recommends to refer the patient to an ophthalmologist, often for cataract surgery, the treatment of glaucoma or for symptoms such as eye flashes and spots. This means that the primary care examination is a good filter and ensures that ophthalmologists can see patients who really need their expertise.”

GPs do not experience an increase in their workload and are happy that their patients do not have to wait long. Especially now that the waiting lists at the outpatient clinic have risen sharply due to the COVID-19 crisis, the primary care eye examination offers a fast and effective alternative.


The primary care eye examination at Star-shl is the result of a special cooperation in the Rotterdam region. In this project, IZER, ZONBOOG and Gezond op Zuid, LHV – Huisartsenkring Rotterdam, Franciscus Gasthuis & Vlietland – Oogziekenhuis Rotterdam, IJsselland hospital, Star-shl and Zilveren Kruis health insurer are working together to speed up ophthalmological care in primary care.

Patients in Rotterdam and the surrounding area no longer need to go to hospital for all ophthalmic care, but can now also quickly turn to the optometrist in primary care. Patients do not pay any excess and can be referred for this examination through ZorgDomein. It does not matter where the patient is insured. The general practitioner will receive an electronic message within two days with the optometrist’s advice.

Right care at the right place

The project runs until January 2022. The effects will be evaluated in the coming years. It is still too early to reach any conclusions regarding savings as a result of substitutions, but it is clear that the patient will be able to receive this form of primary care diagnostic testing if all quality requirements are met.