Nurse prescribing in glaucoma

To investigate a nurse-led assessment clinic of new referrals of possible glaucoma. To determine the potential for nurse prescribing. To review the background literature about nurse prescribing.

Audit of the outcomes of patients attending the nurse-led glaucoma assessment clinic during two defined periods (169 patients). An audit of all patients started on timolol or latanoprost treatment by a nurse following a protocol.

A total of 46 patients were commenced on treatment at the clinic, 31 on timolol, 14 on latanoprost, and one on brimonidine. Four of these had the treatment stopped at the review clinic in order to reassess the diagnosis. Four patients in the timolol group developed side effects requiring a change in medication, but these could not have been predicted from their past medical history. Nine patients had treatment changed or added to because the intraocular pressure was felt to be inadequately controlled. During the two 3-month audits, a further 11 patients were commenced on treatment for glaucoma at the review clinic.

Initial data from this clinic suggest that nurses possess the diagnostic skills necessary to prescribe for new glaucoma patients. The legal and administrative frame works are developing for more nurses to be able to prescribe. With the newer prostaglandin treatments for glaucoma being available, nurses may usefully and safely be able to prescribe first-line treatments for glaucoma.