Current Issues in Glaucoma
NICE Commisioning Guidance for services for people at risk of developing glaucoma – updated March 2012
NICE quality standards for Glaucoma – launched 31 March 2011
NICE Quality Standards on Glaucoma launched 31 March 2011. NICE quality standards are markers of excellence in patient care. They are aimed at patients and the public, health and social care professionals, commissioners and service providers.
Joint Royal College of Ophthalmologists and College of Optometrists Group Letter to PCTs and Directors of Commissioning – December 2010 The College of Optometrists and the Royal College of Ophthalmologists have been working together to address the rise in referrals that the Hospital Eye Service has seen since the publication of the NICE Guideline on Glaucoma. We believe that false positive referrals would be significantly reduced if PCTs commissioned a service from community optometrists for repeating pressure measurements by Goldman-style Contact Applanation Tonometry. This Joint Royal College of Ophthalmologists and College of Optometrists Advice on Contact Applanation Tonometry explains how PCTs could make considerable savings by facilitating this.
The Joint Group on NICE Glaucoma Guideline has published revised guidance on the referral of Glaucoma suspects by community optometrists and supplementary guidance on supervision in relation to glaucoma-related care by optometrists. These have been issued jointly by the College of Optometrists and the Royal College of Ophthalmologists and are endorsed by the Association of Optometrists and the Federation of Ophthalmic and Dispensing Opticians.
The revised guidance, which comes into effect immediately, clarifies the referral criteria, reinforces the status of the guidance and the clinical judgement of the optometrist and clarifies the procedure for using non-contact tonometers.
The group has also issued supplementary guidance which sets out the principles of supervision in the context of the NICE Guideline on Glaucoma published in April 2009. As a result of differing interpretations, many hospital eye departments have experienced a considerable increase in the number of patients referred with suspected glaucoma, many of whom after further investigation were found to have neither glaucoma nor ocular hypertension.
Where colleagues are having problems with an increase in false positive referrals with inadequate clinical information we recommend you ask your Trust to contact your Primary Care Trusts and agree referrals be returned for that information to be provided before offering an appointment.