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Efficiency of referral for suspected glaucoma
BMJ (Clinical Research Ed.)
|April 27, 1991
Summary
Optometrist referrals for suspected glaucoma are efficient when optic discs or visual fields are noted, but improved cooperation and comprehensive testing are needed. Further monitoring and timely appointments are crucial for glaucoma management.
Area of Science:
- Ophthalmology
- Optometry
- Public Health
Background:
- Glaucoma is a leading cause of irreversible blindness.
- Early detection and referral are critical for effective glaucoma management.
- Optometrists play a key role in the initial screening and referral of patients with suspected glaucoma.
Purpose of the Study:
- To evaluate the effectiveness of optometrist referrals for suspected glaucoma.
- To assess the diagnostic accuracy and waiting times associated with these referrals.
- To identify areas for improvement in the referral pathway.
Main Methods:
- A prospective survey of sight tests conducted by optometrists in England and Wales.
- Analysis of 704 referred patients with suspected glaucoma, including diagnoses from consultant ophthalmologists.
- Assessment of waiting times for National Health Service (NHS) appointments.
Main Results:
- Glaucoma was confirmed in 283 of 704 referred patients; 222 required further monitoring.
- Referral accuracy improved when optometrists noted suspicious optic discs or visual field loss.
- Median waiting time for an NHS appointment was nine weeks, with high-risk patients facing delays.
Conclusions:
- Enhanced cooperation between optometrists, general practitioners, and ophthalmologists is essential.
- Optometrists should conduct comprehensive testing (ophthalmoscopy, tonometry, perimetry) before referral.
- Improved communication, including consistent feedback of diagnoses to optometrists, is recommended.