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1 General aspects (0)   1.1 Epidemiology (16)   1.2 Population genetics (1)   1.3 Pathogenesis (1)   1.4 Quality of life (7)   1.5 Glaucomas as cause of blindness (7)   1.6 Prevention and screening (9) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (5)   2.2 Cornea (21)   2.3 Sclera (3)   2.4 Anterior chamber angle (7)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (5)     2.5.2 Schlemms canal (2)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (3)     2.6.1 Production (0)     2.6.2 Outflow (0)       2.6.2.1 Trabecular meshwork (0)       2.6.2.2 Uveoscleral (1)     2.6.3 Compostion (2)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (7)   2.9 Ciliary body (1)   2.10 Lens (0)   2.11 Vitreous body (2)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (2)   2.13 Retina and retinal nerve fibre layer (25)   2.14 Optic disc (20)   2.15 Optic nerve (2)   2.16 Chiasma and retrochiasmal central nervous system (2)   2.17 Stem cells (1)   2.20 Other (1) 3 Laboratory methods (0)   3.1 Microscopy (0)   3.2 Electron microscopy (0)   3.3 Immunohistochemistry (1)   3.4 Molecular genetics (1)     3.4.1 Linkage studies (2)     3.4.2 Gene studies (25)   3.5 Molecular biology incl. 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Miscellaneous (18)

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Abstract #26608 Published in IGR 12-3

The Peterborough scheme for community specialist optometrists in glaucoma: A feasibility study

Syam P; Rughani K; Vardy SJ; Rimmer T; Fitt A; Husain T; McInerney L; Broome D; Driver R; Wormald R
Eye 2010; 24: 1156-1164

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Purpose This study assessed the role of specialist optometrists who were working in the community and sharing the care for glaucoma patients with, and under close supervision of, a consultant ophthalmologist working in the Hospital Eye Services (HES) to ensure high-quality standards, safety, and care.MethodsFrom February 2005 onwards, the majority of all new glaucoma referrals to our eye department were diverted to our specialist optometrists in glaucoma (SOGs) in their own community practices. Selected patients in the HES setting who were already diagnosed with stable glaucoma were also transferred to the SOGs. The completed clinical finding details of the SOGs, including fundus photographs and Humphrey visual field tests, were scrutinised by the project lead. Results This study included 1184 new patients seen by specialist optometrists between February 2005 and March 2007. A total of 32% of patients were referred on to the hospital, leaving the remaining 68% patients to be seen for at least their next consultation in the community by the SOGs. The following levels of disagreement were observed between SOGs and the project lead: on cup:disc ratio (11%), visual field interpretation (7%), diagnosis (12%), treatment plan (10%), and outcome (follow-up interval and location) (17%). Conclusion This study indicates that there is potential for a significant increase in the role of primary care optometry in glaucoma management. The study also confirms a need for a significant element of supervision and advice from a glaucoma specialist. The important issue of cost effectiveness is yet to be confirmed.

S. Ramirez-Florez. Department of Ophthalmology, Peterborough District Hospital, Sutton Wing, Thorpe Road, Peterborough, Cambs PE3 6DA, United Kingdom. susana.ramirezflorez@pbh-tr.nhs.uk

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Classification:

14 Costing studies; pharmacoeconomics

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