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  • Title: The Peterborough scheme for community specialist optometrists in glaucoma: results of 4 years of a two-tiered community-based assessment and follow-up service.
    Author: Roberts HW, Rughani K, Syam P, Dhingra S, Ramirez-Florez S.
    Journal: Curr Eye Res; 2015 Jul; 40(7):690-6. PubMed ID: 25310852.
    Abstract:
    AIMS: To report on results of an innovative glaucoma shared-care scheme based in Peterborough, UK. METHODS: A retrospective review of all new appointments with 11 community-based specialist optometrists in glaucoma (SOG) was conducted. There are two tiers of SOG, whereby tier 2 SOGs have increased levels of autonomy. All optometrist assessments were reviewed by a consultant ophthalmologist, and levels of agreement were calculated for assessment of optic nerve head appearance, Humphrey visual field test interpretation, diagnosis and outcome. RESULTS: 1639 new patients were assessed by SOGs over a 4-year period. The median waiting time for patients from referral to SOG assessment was 0 days (IQR 0-56), and from SOG assessment to consultant review in a virtual clinic was 12 days (IQR 8-18days). After first appointment, over 60% of patients were classified as low-risk and remained within the SOG scheme. Rates of frank disagreement between SOG and consultant regarding diagnosis and proposed outcome were 5.6 and 10.4%, respectively, for tier 2 SOGs and 15.3 and 28.6%, respectively, for tier 1 SOGs. CONCLUSIONS: The SOG scheme demonstrates acceptable levels of accuracy between SOG and glaucoma consultant. This scheme allows many stable low-risk patients to remain out of hospital eye department outpatient clinics.
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