Glaucoma ServicesNorthern Ireland

NICE Glaucoma

Diagnosis and management of chronic open angle glaucoma and ocular hypertension

Introduction

The glaucoma problem

•Estimated 25 - 40% outpatient visits are glaucoma related

•Massive rising demand dictates that low complexity work be shifted into the community where it is more feasible

Diagnosis, OHT, Suspect, COAG

Service Provision

Recommendation

The platform

AOP, ABDO, FODO

•Strongly advised to refer all patients with IOP > 21 mmHg, regardless of instrument

False Negative

Current Provision•2 glaucoma clinics per week in Belfast

•Hospital shared care, optom & 2 nurse specialists

•Less than half visual field capacity

•One imaging device

•Reviews often one year behind

Current Equipment•Expensive imaging requiring trained

personnel

•Inability to purchase equipment

•Not used appropriately as system too stressed

Interventional Provision

•At least 2 surgical glaucoma cases per week

•Require 4 – 25 consults in 1st month

•Consultant intensive

Notes, records, reviews, RVH

•No notes

•90 % notes chronologically inaccurate

•Abysmal

Shared Care•Team required

•Large numbers patients seen by glaucoma capable personnel

•Access to consultant

•Appropriate visual fields and imaging immediately available

•Glaucoma lifelong