We thank Dr Camargo-Parra and colleagues for their comments on our article. They note our acknowledgement of limitations and go on to use some of the findings to conclude that in their view the role of nurses in eyecare should not include that of making a diagnosis of glaucoma. We can agree that patients still require diagnoses to be consultant-led, and this requirement becomes particularly important for secondary glaucomas or other conditions which may mimic glaucomatous signs and symptoms, including other ocular or neurological disease, a point within the NICE glaucoma guideline and their recommendations on the role of non-medical health care professionals in glaucoma; however, to infer that our paper is about diagnosing glaucoma misses the point. Our evaluation demonstrates how an ophthalmic nurse practitioner can upskill within glaucoma assessment to allow enhancement of capacity in glaucoma clinics, which in the context of the UK’s Hospital Eye Service would reflect working within a consultant-led glaucoma service. Indeed, there is support from the Royal College of Ophthalmologist and NICE for development of such roles [1,2,3,4]. Misclassification errors in glaucoma may be found in other professional groups when compared to glaucoma specialists, including ophthalmologists in training [5], arguably a scenario not unexpected during training where clinical supervision is in place. We also note Dr Camargo-Parra’s view that “without a clear and replicable pathway of training, it is unfair to pretend that nurse practitioners can provide glaucoma care”. We disagree and believe that such a view is out-dated. In the UK, it is widely accepted that multi-disciplinary care is essential to develop capacity in glaucoma services, and, furthermore training and accreditation for non-medical roles in the glaucoma care pathway are well defined and can be replicated [6].

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