glaucoma services northern ireland. nice glaucoma diagnosis and management of chronic open angle...
Post on 28-Mar-2015
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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
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