Abstract
Purpose
To establish whether the effect of improved glaucoma detection in the community suggested by an intervention study is maintained when intervention is extended to include all optometrists in the area.
Methods
Optometrists’ in the Ealing, Hammersmith, and Hounslow area were invited to ongoing training sessions following completion of an intervention study. The number of optometrist initiated referrals to Ealing Hospital Eye Clinic (EHEC) for suspect glaucoma was assessed over a 12-month period. The positive predictive value (PPV) of those referrals was calculated and a historical comparison made with the results of the original study.
Results
A total of 376 new referrals for suspected glaucoma were assessed at EHEC during the 12-month period of data collection. This represents an increase in the number of referrals of 58% compared with an equivalent 12-month period during the initial intervention trial (376 vs238). The PPV was maintained at 0.45 (95% CI 0.41–0.51).
Conclusion
The rising number of new referrals for glaucoma together with maintenance of the PPV suggests an impact on the number of new cases of glaucoma detected in the community. The increase in referral numbers was limited to glaucoma when compared with new referrals for cataract. This implies a targeted effect of the intervention in terms of glaucoma detection. We believe the next step is to perform the study in an alternative location to see if the effect is repeatable elsewhere. If proven to be the case, there is a coherent argument for widespread adoption of this strategy to improve glaucoma case finding.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Sheldrick JH, Ng C, Austin DJ, Rosenthal AR . An analysis of referral routes and diagnostic accuracy in cases of suspected glaucoma. Ophthal Epidemiol 1994; 1: 31–39.
Bell RWD, O’Brien C . Accuracy of referral to a glaucoma clinic. Ophthal Physiol Opt 1997; 17 (1): 7–11.
Newman DK, Anwar S, Jordan K . Glaucoma screening by optometrists: positive predictive value of visual field testing. Eye 1998; 12: 921–924.
Pooley JE, Frost EC . Optometrists’ referrals to the Hospital Eye Service. Ophthal Physiol Opt 1999; 19: S16–S24.
Lash SC . Assessment of information included on the GOS 18 referral form used by optometrists. Ophthal Physiol Opt 2003; 23: 21–23.
Theodossiades J, Murdoch IE . Positive predictive value of optometrist initiated referrals for glaucoma. Ophthal Physiol Opt 1999; 19: 62–67.
Vernon SA, Henry DJ . Do optometrists screen for glaucoma? Eye 1989; 3: 131–134.
Tuck MW, Crick RP . Efficiency of referral for suspected glaucoma. BMJ 1991; 302 (6783): 998–1000.
Theodossiades J, Murdoch IE, Cousens S . Glaucoma case finding: a cluster-randomised intervention trial. Eye 2004; 18: 483–490.
Vernon SA, Ghosh G . Do locally agreed guidelines for optometrists concerning the referral of glaucoma suspects influence referral practice? Eye 2001; 15: 458–463.
Henson DB, Spencer AF, Harper R, Cadman EJ . Community refinement of glaucoma referrals. Eye 2003; 17: 21–26.
Acknowledgements
We thank the Ealing, Hammersmith and Hounslow optometrists for their ongoing interest and support. The International Glaucoma Association supported the original intervention study. Frank Munroe kindly provided the information for cataract referral numbers for this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Patel, U., Murdoch, I. & Theodossiades, J. Glaucoma detection in the community: does ongoing training of optometrists have a lasting effect?. Eye 20, 591–594 (2006). https://doi.org/10.1038/sj.eye.6702000
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.eye.6702000
Keywords
This article is cited by
-
Systematic review of the appropriateness of eye care delivery in eye care practice
BMC Health Services Research (2019)
-
Optometrists referrals for glaucoma assessment: a prospective survey of clinical data and outcomes
Eye (2010)
-
The influence of socioeconomic and clinical factors upon the presenting visual field status of patients with glaucoma
Eye (2009)
