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Updated: May 18, 2026
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Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
Comparison of optometrist glaucoma referrals against published guidelines
Sheema Khan1, Jonathan Clarke, Aachal Kotecha
1NIHR Biomedical Research Centre for Ophthalmology, UCL Institute of Ophthalmology and Moorfields Eye Hospital NHS Foundation Trust, London, UK.
Summary
Community optometrists often do not follow guidelines for referring glaucoma suspects. Reminding practitioners about recommended intraocular pressure (IOP) measurement protocols can improve referral accuracy.
Area of Science:
- Ophthalmology
- Optometry
- Public Health
Background:
- Glaucoma suspect referrals are crucial for early detection and management.
- Published guidelines exist to standardize the referral process for patients with suspected glaucoma.
- Adherence to these guidelines by community optometrists is essential for efficient hospital eye service utilization.
Purpose of the Study:
- To evaluate community optometrists' adherence to established guidelines for referring patients with suspected glaucoma.
- To assess the quality of data provided in referral letters, specifically intraocular pressure (IOP) measurements and tonometry methods used.
Main Methods:
- A retrospective audit of new referrals to a hospital glaucoma service was conducted.
- Referral data, including IOP measurements and tonometers used, were compared against 2009 guidelines.
- 114 optometrist-initiated referrals were analyzed.
Main Results:
- Most optometrist referrals (97%) included IOP measurements, primarily using non-contact tonometry (NCT).
- However, many practitioners did not adhere to the recommended number of NCT readings per eye.
- A significant proportion of referrals (43%) were for raised IOP in isolation, with many subsequently discharged after hospital assessment.
Conclusions:
- Community optometrists should be reminded of guidelines regarding the number of IOP measurements and the value of repeat measures.
- Improving adherence to measurement protocols can enhance the accuracy of glaucoma suspect referrals.
- This optimization can lead to more appropriate utilization of hospital eye services.
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