Aim: To investigate the impact of an interdisciplinary low vision service on the vision related quality of life of service users. Methods: 71 patients were interviewed 2 weeks before their appointment with the service and again 6 months later to assess any changes in their vision related quality of life. The majority of these patients had age related macular degeneration. Results: After contact with the service the majority of patients indicated a reduction in concern about most quality of life issues. They were significantly less anxious about deterioration of their vision, safety within the home, and coping with everyday life. Conclusion: Improvements in many areas of their vision related quality of life indicate that this interdisciplinary low vision service has a positive impact on the lives of service users. However many patients were still unable to carry out their preferred everyday activities, and feelings of loneliness and isolation were unchanged. The identification of issues unrelieved by input from the service will be important in planning future service delivery.

Many developed industrialized countries perceive considerable value in developing practice based research networks. In this paper, the development of the Scottish Primary Care Research Network (SPCRN) from 1924 -2013 is described. After a false start in the early twentieth century and some local developments 10 -15 years ago, the Scottish Primary Care Research Network was fi nally built upon existing networks of teaching and training practices centred on research active departments of general practice and primary care. This meant that a climate already favourable to research existed and several of the necessary skills were available. Long-term funding commitment to the network by the National Health Service meant that the infrastructure could be developed in the knowledge that it would be likely to become incorporated into wider Scottish and UK systems. Two-thirds of Scottish practices regularly participate in research at a rate of 50 -60 studies each year, which result in a range of publications that infl uence clinical decisions and health policy. As the success of the network grows, greater demands are placed upon it, and the capacity of practices to continue to engage in research may be tested.

The aim of this study was to determine the characteristics of the patients in Fife who were registered as blind with a main diagnosis of glaucoma between 1990 and 1999. The case notes of 87 people were studied. The average age at registration was 78 years (S.D. = 14). By the time of first referral to hospital, more than half were already aware of visual loss. Forty-five per cent of referrals had no optometry input. Compliance with treatment was poor in at least 26% of patients. Only 44% had glaucoma surgery. There were significant findings with regard to mental health, particularly dementia, which was eventually present in 24%. At least one-third of patients had a hearing impairment. One-third of those registered as blind could have been registered earlier. However, staff from the local provider of rehabilitation and social work services for the blind were shown to have provided prompt and helpful support to 95% of those registered. Consideration should be given to the way in which elderly patients with advanced glaucoma are managed, with awareness of mental health and hearing problems and emphasis on early referral to rehabilitation services.

Purpose: to study patient characteristics and management profile in advanced glaucoma. Method: A retrospective study of 87 case notes of patients registered blind due to glaucoma, and cross-sectional interview of 29 patients. Results: advanced glaucoma at presentation was documented in 43 cases (49%). Insufficient optometry assessment was significantly associated with advanced disease (p = 0.0339). Normal tension glaucoma patients were significantly more likely to present with advanced disease compared to other types of glaucoma (p = 0.0034). Poor compliance with medication was significantly higher in those with hearing loss (p = 0.0168). Patients with advanced field defect at presentation and those with poor compliance had significantly higher social deprivation scores compared to others on the blind register (p < 0.0001). Nine (10%) patients had partial registration before full registration and 29 (33%) patients had late registration. Of the 29 patients interviewed, 20 (69%) did not demonstrate basic knowledge regarding their disease or its management; nor had they received written information on glaucoma or instructions on drop technique. Conclusion: Special care pathways are required in advanced glaucoma taking into account co-existent morbidity, disease education and compliance.

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