The diagnostic outcome of new glaucoma referrals

A retrospective cohort study of the case notes of 295 patients referred to the glaucoma clinic at the Royal Infirmary of Edinburgh between October 1993 and March 1994 was performed. The purpose of the study was to determine the diagnostic outcome of new referrals suspected of having glaucoma, all of whom were examined by a single glaucoma specialist. The largest diagnostic group was ocular hypertension (113, 42%), just over half of which were started on treatment. A new diagnosis of glaucoma was confirmed in 46 patients (17%). In total, 107 patients (39%), required treatment (46 glaucoma and 61 ocular hypertension). Thirty-six percent of new referrals were either discharged (80, 29%) or had other ocular conditions unrelated to glaucoma (19, 7%). A proportionately high number of new glaucoma cases (15 out of 46) had normal intraocular pressures, which emphasises the important role of ophthalmoscopy and perimetry in case detection. In conclusion, the number of newly diagnosed cases of glaucoma (17%) is considerably less than previous reports (22-39%), with a high proportion of referrals (2 in every 5) having ocular hypertension.