We read with interest the brief communication by Hunt et al. [1]. We agree that oculoplastics poses challenges for digital conversion to an electronic medical record (EMR), given the extensive use of static and dynamic measurements, and diagrammatic representation. Generic ophthalmology templates would not be suitable for accurate recording of many oculoplastic examination findings or interventions and the nuances of this are ill-suited to the use of drop-down menus.

Recognising this, the authors convened an Oculoplastic Working Group to design a series of easily adjustable, detail-oriented purpose-built modules for recording oculoplastic findings accurately within OpenEyesTM (Apperta Foundation; Sunderland, United Kingdom) [2], one of several ophthalmology-focused EMRs available in the UK. The need for this was raised at the British Oculoplastic Surgery Society (BOPSS) AGM in 2019 by the group in an attempt to encourage collaboration. These modules, which should be available to all users in the near future, include adjustable eyelid doodles including the ability to indicate lesions, lash loss, and malposition; orbital examination and pathology; and charts for recording administration of Botox with full face representation. Further modules (e.g., lacrimal syringing) are planned for future development. Once these changes are live, we plan to conduct a survey of BOPSS members to establish a consensus on an oculoplastic minimum dataset for EMRs in general.

Although there is an initial time-consuming learning curve, EMRs do provide comparable information to handwritten clinical notes when used correctly. As seen with cataract, glaucoma, and medical retinal subspecialties, an EMR can offer additional advantages in terms of data collection and audit [3] proving invaluable during the Covid pandemic when used for remote/virtual patient care. This, coupled with the NHS Long Term Plan commitment to providing digital access to health records [4], means adoption of EMRs remains a priority. Whilst the concurrent use of photographic images and detailed clinic letters to document findings might help address the oculoplastic shortcomings of a generic ophthalmology EMR, oculoplastic surgeons should be encouraged to follow the lead in ensuring EMRs are designed with oculoplastics in mind, or risk being stuck with a platform which is not fit for purpose.