National UK optometry clinical practice survey: implications for developing glaucoma services in primary care

In the context of insufficient capacity in glaucoma services to meet demand, this paper aimed to assess optometrists' current and potential involvement in glaucoma care, with a primary focus on their willingness to pursue further qualifications and take on expanded roles in primary care. Secondary objectives included describing professional demographics, clinical practice patterns and the availability of diagnostic equipment and IT infrastructure.

This paper reports on responses from 1009 optometrists across the UK who completed the 2023 Clinical Practice Survey (CPS) conducted by the College of Optometrists.

Of 1009 CPS participants, 86% (n = 824) were primary care optometrists, while the remainder worked in secondary care and other settings. Among primary care optometrists, 33% (n = 272) reported providing glaucoma repeat measures, 25% (n = 207) providing enhanced case finding or higher-level filtering services, and 9% (n = 77) were involved in the co-management of stable/low-risk glaucoma within their practice. CPS data indicated that 24% (n = 238) optometrists plan to focus their professional development on glaucoma in the next 12 months, 15% (n = 109) plan to pursue a professional certificate, 6% (n = 53) a higher certificate, 4% (n = 34) a diploma and 20% (n = 147) independent prescribing. In relation to diagnostic tools, 94% optometrists reported having contact tonometry available, 99% had access to a visual field analyser, 42% to OCT, 57% to pachymeters and 40% to gonioscopes. Regarding referrals, 72% of primary care optometrists were able to make electronic referrals, with the most common methods for e-referrals being NHS email (44%) and referral portals (36%).

UK optometrists appear very willing to upskill in glaucoma in terms of undertaking higher qualifications, developing clinical skills, and offering relevant services, potentially alleviating significant pressure on NHS secondary care glaucoma services.