The part Optometrists play in Glaucoma

Optometrists’ ‘key role’ in caring for glaucoma patients

OPTOMETRISTS have a key role in caring for glaucoma patients as part of a more integrated care system, say experts.

As Glaucoma Awareness Week (26 June – 2 July) gets underway, Specsavers is working with charity Glaucoma UK to highlight the importance of regular eye tests and the role of optometrists helping to detect and monitor glaucoma in patients in community settings. Hundreds of thousands of people in the UK have glaucoma – which can cause vision loss – but are unaware that they do, says the charity.

Professor Anthony King, Chair of Glaucoma UK, says that glaucoma is a complex disease and difficult to assess. ‘Optometrists have a key role because for most people the signs of glaucoma are first spotted during a routine eye test,’ he adds.

‘For lower risk patients, optometrists also have an ongoing role in monitoring their eye health and helping them to manage their condition by supporting them to take their medication and attend all their follow up appointments.’

This role for optometrists has for example, proved critical in Greater Manchester, says optometrist Kevin Liu. He worked with other primary care optometry practices in partnership with the NHS in Greater Manchester to support hundreds of patients with diagnosed or suspected glaucoma in the community.

Services are delivered through two pathways: the Glaucoma Enhanced Referral service (GERS), which filters referrals from other services, and the stable glaucoma monitoring service in Greater Manchester – which is called Primary Eyecare Glaucoma Service (PEGS).

Patients benefit through the timely detection and monitoring of the condition, says Mr Liu who was a partner in three Specsavers practices in Altrincham, Sale and Urmston.

‘GERS helps us to find those patients who may have glaucoma while improving the quality of the referrals being sent to hospital. Ensuring the right patients are referred into secondary care ophthalmology services optimises the use of resources. This should continue to make life easier for our hospital colleagues and allow them to focus their care on those who need it.

‘Through the glaucoma monitoring service, patients have their glaucoma tests completed within the community. Results are shared securely with the patient’s ophthalmologist. This joined up approach helps to streamline the experience for the patient and ensures that optometry practices and ophthalmologists work together for the benefit of the patient.’

Prior to the pandemic, referral filtering through repeat measures was considered as good practice. Some areas showed this avoided 50% of referrals and reducing false positives, notes Mr Liu.

Research by Specsavers has also previously highlighted how a fifth of the population still don’t know how often they should visit their optician for a routine check-up, with the same percentage either unable to remember their last eye examination or having never had one. Research by the General Optical Council also showed that less than one in four had an eye test in the last two years.

Now a Specsavers Clinical Performance Consultant supporting optometrists’ development, Mr Liu says that gaining additional qualifications – such as Professional Certificate in Glaucoma and Independent Prescribing – and encouraging colleagues to do the same, has been central to the success of the community services.

‘When the pandemic hit and services needed to be restructured, we were ready to go and already prepared as an upskilled workforce with the right qualifications. Trafford had very little enhanced optical services before Covid. Covid was a unique situation.

The new community services allowed us to build much closer relationships with the eye hospital and with local GPs allowing us to work together effectively for the benefit of patients.

‘We learned a lot and provided great care for the community – and we are now using those learnings to improve the quality of primary eye care for our patients.

‘Although glaucoma referral filtering and monitoring services are commissioned more consistently throughout England, eye care leaders are calling for greater integration of care,’ Mr Liu adds.

Joanne Creighton, Chief Executive of Glaucoma UK says, ‘As a charity that provides help and support to everyone living with glaucoma, Glaucoma Awareness Week is an opportunity to highlight the fact that an estimated 350,000 people in the UK have glaucoma but are unaware.

‘Glaucoma can be symptomless, and people could lose sight to the disease before they’re able to spot the signs. An optometrist can identify glaucoma at a routine eye appointment at your local optician store, which is why we urge everyone to book an eye test and save their sight.’