NICE’s updated guideline on glaucoma made recommendations relating to referral. The introduction of referral filtering measures following a sight test leads to fewer people being referred for specialist investigation and a greater number being managed within primary care.
Whilst people with low risk of developing glaucoma can avoid referral to the hospital eye service, others with a diagnosis but low risk of progression, can be appropriately monitored in optical practice.
LOCSU has produced an integrated service pathway which aims to identify patients with ocular hypertension and suspected COAG and manage them in primary care, only referring those who require specialist investigation. The pathway supports integration, helping to ensure a whole system solution for patients with glaucoma, or glaucoma-related conditions, helping to address capacity pressures within the overburdened hospital glaucoma clinics.
LOCSU has developed a comprehensive Clinical Service Pathways Framework incorporating, which will be reviewed in 2025:
- Integrated Glaucoma Service Pathway Diagram
- Integrated Glaucoma Monitoring Pathway Diagram
- Integrated Glaucoma Patient Experience Questionnaire
- LOCSU Glaucoma Repeat Readings Pathway Diagram
- LOCSU Glaucoma Repeat Readings Clinical Management Guidelines
- Glaucoma Repeat Readings Patient Experience Questionnaire
- LOCSU Glaucoma Enhanced Case Finding Pathway Diagram
- LOCSU Glaucoma Enhanced Case Finding Clinical Management Guidelines
- LOCSU Glaucoma Referral Refinement & Differential Diagnosis Pathway Diagram
- LOCSU Glaucoma Referral Refinement & Differential Diagnosis Clinical Management Guidelines
Other Useful Documents
- NICE guidance NG81
- SAFE framework for Glaucoma – Clinical Council for Eye Health Commissioning
- College of Optometrist member briefing on NICE guidance on Glaucoma
Case Studies
Glaucoma Filtering and Monitoring Case Studies
Patient Health and Care Videos
A range of patient-facing videos have been written and produced by HCI which can be used to assist in the continuation and improvement of eye care services, supporting people to understand transformations in care pathways such as remote consultations, and management of their eye conditions, with easy to understand content that explains risk, consent, options for treatment, options for support and self-care including post-surgery.
The glaucoma library can be found here and includes a range of areas including:
The full library of videos can be found here.
Skills and Training
- Contact and register with WOPEC (Wales Optometry Postgraduate Education Centre)
- College of Optometrists’ Professional Certificate in Glaucoma