NICE’s updated guideline on glaucoma made recommendations relating to referral. The introduction of referral filtering measures following a sight test leads to fewer people being referred for specialist investigation and a greater number being managed within primary care.
Whilst people with low risk of developing glaucoma can avoid referral to the hospital eye service, others with a diagnosis but low risk of progression, can be appropriately monitored in optical practice.
LOCSU has produced an integrated service pathway which aims to identify patients with ocular hypertension and suspected COAG and manage them in primary care, only referring those who require specialist investigation. The pathway supports integration, helping to ensure a whole system solution for patients with glaucoma, or glaucoma-related conditions, helping to address capacity pressures within the overburdened hospital glaucoma clinics.
LOCSU has developed a comprehensive Clinical Service Pathways Framework incorporating:
- Integrated Glaucoma Service Pathway Diagram
- Integrated Glaucoma Monitoring Pathway Diagram
- Integrated Glaucoma Patient Experience Questionnaire
- LOCSU Glaucoma Repeat Readings Pathway Diagram
- LOCSU Glaucoma Repeat Readings Clinical Management Guidelines
- Glaucoma Repeat Readings Patient Experience Questionnaire
- LOCSU Glaucoma Enhanced Case Finding Pathway Diagram
- LOCSU Glaucoma Enhanced Case Finding Clinical Management Guidelines
- LOCSU Glaucoma Referral Refinement & Differential Diagnosis Pathway Diagram
- LOCSU Glaucoma Referral Refinement & Differential Diagnosis Clinical Management Guidelines
Two LOCSU case studies relating to the measurement of intraocular pressure (IOP) in optical practice are available:
- Explore the impact of the NICE glaucoma guidelines on referral activity
- Glaucoma Repeat Readings – how many repeats are needed?
Other Useful Documents
- NICE guidance NG81
- SAFE framework for Glaucoma – Clinical Council for Eye Health Commissioning
- College of Optometrist member briefing on NICE guidance on Glaucoma