Abstract
Purpose
This study assessed the role of specialist optometrists who were working in the community and sharing the care for glaucoma patients with, and under close supervision of, a consultant ophthalmologist working in the Hospital Eye Services (HES) to ensure high-quality standards, safety, and care.
Methods
From February 2005 onwards, the majority of all new glaucoma referrals to our eye department were diverted to our specialist optometrists in glaucoma (SOGs) in their own community practices. Selected patients in the HES setting who were already diagnosed with stable glaucoma were also transferred to the SOGs. The completed clinical finding details of the SOGs, including fundus photographs and Humphrey visual field tests, were scrutinised by the project lead.
Results
This study included 1184 new patients seen by specialist optometrists between February 2005 and March 2007. A total of 32% of patients were referred on to the hospital, leaving the remaining 68% patients to be seen for at least their next consultation in the community by the SOGs. The following levels of disagreement were observed between SOGs and the project lead: on cup:disc ratio (11%), visual field interpretation (7%), diagnosis (12%), treatment plan (10%), and outcome (follow-up interval and location) (17%).
Conclusion
This study indicates that there is potential for a significant increase in the role of primary care optometry in glaucoma management. The study also confirms a need for a significant element of supervision and advice from a glaucoma specialist. The important issue of cost effectiveness is yet to be confirmed.
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Acknowledgements
We thank NHS Modernisation Agency, A Kent, H McLeod, S Westwood, S Broome, S Urquart, G Sondh, C Pirrie, N Guttridge-Smith, A Clark, M Manak, R Whitehead, C Love, M A Omar, J Winder, J Avery, B Stevenson, P Gorst, S Westwood, A Stone, S Cumley, R Heywood, J Nair, P Alexander, G Lewis, S Hodnett, S Sood, R Adams, Peter Murray, and the nursing staff of Peterborough eye department. This project was funded by the UK Department of Health through the Modernisation Agency as one of the selected pilot sites to develop a model for a glaucoma care pathway.
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This paper was presented as a poster at the 2006 annual congress of the Royal College of Ophthalmologists and as a presentation and poster at the Oxford Congress 2007
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Syam, P., Rughani, K., Vardy, S. et al. The Peterborough scheme for community specialist optometrists in glaucoma: a feasibility study. Eye 24, 1156–1164 (2010). https://doi.org/10.1038/eye.2009.327
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DOI: https://doi.org/10.1038/eye.2009.327
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