Expansion of community glaucoma monitoring service
Patients under the care of Ophthalmology at the Norfolk and Norwich University Hospital (NNUH) will be monitored by community optometrists as a pre-pandemic service resumes.
The Norfolk Community Glaucoma Suspect Monitoring Scheme (NCGSMS) was set up for patients identified by the NNUH Glaucoma service as being at elevated risk of developing glaucoma, but who don’t currently require treatment.
These low risk ‘glaucoma suspects’ can be seen by an accredited community optometrist (local optician) rather than remaining under hospital care. This frees up valuable capacity in the eye clinic and allows the patient to be seen by a suitably qualified clinician nearer to their home. Before the pathway was paused with the onset of the COVID-19 pandemic, over 1000 patients were already placed into the pathway, potentially freeing up to 5000 eye clinic appointments.
Dr Dan Rosser, Consultant Optometrist within the NNUH Glaucoma Service said: “Around 99 per cent of referrals for suspect glaucoma come from community optometrists. These patients require follow-up as glaucoma is irreversible and usually remains symptomless until the advanced stages. As such, patients require an annual review with a suitably skilled and qualified clinician to avoid late detection of the disease. As eye specialists based in primary care, community optometrists are perfectly placed to provide this service, and at a lower cost to the commissioner than attending an acute Trust. The optometrist sees the patient annually for five years and refers the patient back to us if they suspect that glaucoma is developing.”
The scheme is funded by the Norfolk and Waveney Integrated Care Board so the additional glaucoma tests are free of charge and can be carried out alongside the patient’s regular NHS sight test.
Community optometrists wishing to be involved must gain accreditation by completing online learning and undergo a practical assessment. The accreditation also enables them to perform a referral refinement function to avoid unnecessary referrals. Eleven clinicians attended the latest assessment session which took place at NNUH in February.
Dr Rosser added: “Our secretarial team are crucial to the success of this pathway as they send the patient’s baseline clinical data to the chosen optometrist in the community via a dedicated IT system. I’d like to thank them for their support in ensuring this service runs smoothly for the benefit of our patients.”
Rose Bliss, Senior Glaucoma Secretary said: “It is reassuring to know that, thanks to the NCGSMS, our patients will still be receiving the care they require and can be returned to us for expert review at any time, should there be any concerns about their vision”.