Evaluation of glaucoma patients referred to a university clinic during one year

In the spring of 1994, the post-referral waiting time for glaucoma patients at our institution was approximately 7 months. In an attempt to evaluate and possibly reduce this waiting time we compared the referral criteria to the actual treatment requirements of 472 patients admitted for glaucoma in 1995.

175 patients were referred as glaucoma suspects, 134 as chronic simple glaucoma, and 123 as capsular glaucoma. In addition, 40 patients were referred as other types of glaucoma. Elevated IOP was the main criterion for referral in 133 (76%) of glaucoma suspects. The diagnosis of glaucoma could not, however, be confirmed in 54 (31%) glaucoma suspects. 93 (69%) patients with simple open angle glaucoma and 103 (84%) patients with capsular glaucoma were also referred because of IOP > or = 22 mmHg. Maximally tolerated medication was not used by 44% of open angle glaucoma patients at time of referral.

The clinical follow-up of glaucoma patients and glaucoma suspects should primarily take place at an ophthalmologist's office and the new effective glaucoma drugs and laser treatments should also be more actively in use. The cooperation between the referring ophthalmologists and the university clinic should be improved. Hospitalisation turned out to be unnecessary because, with a few exceptions, all procedures could have been performed on an out-patient basis, which is a general practice in most glaucoma clinics today. The university clinic should focus only on those patients who need special evaluation or surgical treatment.