Primary Eyecare Glaucoma Service (PEGS): a mixed methods service evaluation.

Area of Science:

• Ophthalmology
• Public Health
• Optometry

Background:

• Glaucoma management requires regular monitoring.
• Secondary care services face increasing demand.
• Primary care optometry offers a potential solution for routine patient care.

Purpose of the Study:

• To pilot and assess the safety and efficacy of a Primary Eyecare Glaucoma Service (PEGS).
• To evaluate the review of low-risk glaucoma patients within primary care optometry settings.

Main Methods:

• 98 low-risk glaucoma patients were monitored in community optometry practices.
• Accredited optometrists used a clinical management plan for reviews.
• Safety was assessed by comparing primary and secondary care management plans.
• Patient and optometrist feedback was collected via surveys.
• Carbon emissions from travel were calculated.

Main Results:

• 93.8% of patients remained suitable for primary care monitoring; 4.9% required secondary care recall.
• Management plan concordance between primary and secondary care was high (97.8%, kappa=0.88).
• No false negatives were identified.
• Patient satisfaction with PEGS was 100%.
• Primary care optometrists reported confidence in delivering care.
• Carbon emissions were reduced by approximately two-thirds.

Conclusions:

• The Primary Eyecare Glaucoma Service (PEGS) is a safe and effective model.
• PEGS reduces the burden on secondary care services.
• The service demonstrates environmental sustainability through reduced carbon emissions.