Glaucoma referral refinement in Ireland: managing the sensitivity-specificity paradox in optometric practice

Ophthalmic & Physiological Optics : the Journal of the British College of Ophthalmic Opticians (Optometrists)
Catriona BarrettJames Loughman

Abstract

Glaucoma referral refinement (GRR) has proven a successful demand management strategy for glaucoma suspect cases in the United Kingdom (UK). A GRR clinic was established in Dublin, Ireland to investigate the clinical viability of this pathway outside the UK's National Health Service (NHS) structures, and away from the influence of National Institute for Clinical Excellence (NICE) guidance. Glaucoma suspect patients were recruited into the scheme following referral from community optometrists in the greater Dublin area. The GRR exam protocol was designed in consultation with the participating ophthalmology department. The refinement scheme optometrist, trained through apprenticeship style experience at a hospital outpatient clinic, made a tentative management decision after carrying out the GRR exam. The final management decision was made in a 'virtual clinic' by a glaucoma specialist consultant ophthalmologist. Two hundred and twenty-five glaucoma suspect patients were seen in the scheme. After their first GRR visit, 28% were discharged back to their own optometrist, 42% were monitored in the GRR clinic, and 30% were referred to ophthalmology. After this monitoring cohort were further assessed, a total of 38% of the patients se...Continue Reading

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Citations

Nov 9, 2019·Eye·Robert A HarperJohn G Lawrenson
Oct 12, 2019·Ophthalmic & Physiological Optics : the Journal of the British College of Ophthalmic Opticians (Optometrists)·Rosalind C CreerRobert A Harper
Mar 11, 2021·Clinical & Experimental Optometry : Journal of the Australian Optometrical Association·Henrietta Wang, Michael Kalloniatis

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