Glaucoma Services
Northern 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 1 month
• Consultant intensive
st
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