<scp>C</scp>ambridge community <scp>O</scp>ptometry <scp>G</scp>laucoma <scp>S</scp>cheme

Keenan, Jonathan; Shahid, Humma; Bourne, Rupert; White, Andrew; Martin, Keith R

doi:10.1111/ceo.12398

Cited by 46 publications

(80 citation statements)

References 27 publications

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“…The present study identified a potential clinical pathway for patients with suspected angle closure spectrum disease, where the majority of patients do not require onward ophthalmological assessment. The overall proportion of all patients who could be discharged back into the community for ongoing optometric care (20.1 per cent) was similar to some previous reports and was lower than others . Specifically with regard to patients referred for angle assessment, gonioscopic findings were not once noted in the referral letter, indicating a gap in current community optometry that is addressed in the present model.…”

Section: Discussionsupporting

confidence: 79%

“…The present study evaluated the effect of a new, recently activated referral pathway on improving triaging effectiveness and patient outcomes for angle closure spectrum disease. This pathway was put in place after noting that other existing glaucoma‐specific patient pathways do not necessarily regard angle closure spectrum disease as a distinct entity requiring a separate triage process. In doing so, this study sought to evaluate potential reasons for pathway utilisation in order to guide further improvements to the system.…”

Section: Discussionmentioning

confidence: 99%

“…The increase in prevalence of glaucoma, as a consequence of an increasing ageing population, will continue to place a burden on health‐care systems, particularly where patients with poorly defined risk factors are referred to an ophthalmologist for diagnosis and management . Collaborative care models in which primary care optometrists deliver diagnostic and treatment services may assist in alleviating the stress upon the relative shortage of ophthalmology services, by specifically reducing the incidence of false positive referrals to ophthalmologists and improving the maintenance of appropriate clinical follow‐up for glaucoma suspect patients . In doing so, ophthalmology services can be directed to the treatment of specific patients with glaucoma, address other demands for specialised eye care, and may ultimately represent cost savings to the health‐care system …”

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confidence: 99%

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A collaborative care pathway for patients with suspected angle closure glaucoma spectrum disease

Phu

Hennessy

Spargo

et al. 2020

Clinical and Experimental Optometry

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Background Currently, no specific collaborative care pathway exists that distinguishes open angle glaucoma from narrow angle or angle closure disease. This study evaluates a newly developed referral and collaborative care pathway specifically for patients with angle closure spectrum disease. Methods The medical records of consecutive patients referred to the Centre for Eye Health for glaucoma assessment were examined, six months before (Pre Suite) and after (Post Suite) the introduction of a novel referral pathway for anterior chamber angle assessment (Angle Suite). Patient demographic and clinical data, the referral letter and practitioner characteristics were extracted. Results Angle Suite (n = 77) patients had an appointment much sooner compared to Pre (n = 383) and Post Suite (n = 425) patients (p < 0.0001). Following the introduction of Angle Suites, there was a reduction of incidental angle closure disease found in routine, non‐angle closure glaucoma assessment. Onward referral was required by 36.4 per cent of patients referred for suspected angle closure disease, while the rest could be discharged back into the community (13.0 per cent) or reviewed at the Centre for Eye Health (50.6 per cent). Multinomial logistic regression found that the presence of an angle description in the referral letter improved the true positive rate for angle closure disease (p < 0.0001). Conclusions The clinical pathway may reduce the number of incidental angle closure patients and improved the timeliness of appropriate clinical care delivered to a subset of patients who may benefit from prompt medical attention. This pathway provides an opportunity for appropriately staffed and equipped collaborative care clinics to reduce the burden on tertiary level ophthalmic facilities.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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A collaborative care pathway for patients with suspected angle closure glaucoma spectrum disease

Phu

Hennessy

Spargo

et al. 2020

Clinical and Experimental Optometry

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“…Early detection and prompt treatment of glaucoma and ocular hypertension may prevent or significantly delay glaucoma‐related visual disability, leading to a better quality of life among affected persons and reduced both direct and indirect costs to the society . Opportunistic cases finding by community‐based optometrists accounted for more than 90% of all glaucoma referrals in the United Kingdom, while office‐based opportunistic screening has been proposed as a feasible model in the United States . In Australia, a hybrid model of collaborative care for glaucoma patients and suspects between ophthalmologists and optometrists have been proposed .…”

Section: Discussionmentioning

confidence: 99%

Integrating opportunistic glaucoma screening into general health examinations in China: A pilot study

Zhang

Sun

Liu

et al. 2019

Clinical Exper Ophthalmology

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Importance Under‐detection and late diagnosis are major causes of glaucoma‐related visual impairment. Cost‐effective opportunistic glaucoma screening is of great interest in the early identification and prevention of glaucoma. Background To describe the results of a health examination centre‐based opportunistic glaucoma screening and referral model. Design This single centre cross‐sectional study was conducted in a health examination centre affiliated to a tertiary hospital in Shenyang, northeastern China. Participants From 21 March to 30 September 2016, 14 367 individuals aged ≥ 30 years undergoing routine physical examinations were invited for this glaucoma screening. Methods Presenting visual acuity, non‐contact pneumotonometry and non‐mydriatic fundus photography were evaluated. Fundus photographs were classified as non‐glaucoma, possible, probable and definitive glaucoma. Participants with probable and definite glaucomatous discs or intraocular pressure ≥ 24 mmHg were referred for definitive examinations. Main Outcome Measures Detection rate of glaucoma suspects and ocular hypertension (OHT). Cost to identify a single case with suspected and diagnosed glaucoma was also calculated. Results Altogether, 277 glaucoma suspects and 327 ocular hypertension suspects were identified. Among 190 participants with probable/definite glaucomatous discs, 93 (48.9%) accepted further examination. Among these, 78 were diagnosed as glaucoma, seven as suspects and eight were excluded. Only 98 ocular hypertension suspects (30.0%) accepted further examinations: eight had primary angle closure and 23 had confirmed ocular hypertension. The cost to identify a single glaucoma suspect and definite glaucoma case were US$135 and US$857, respectively. Conclusions and Relevance This novel screening model provides opportunities to improve glaucoma detection at low cost. Interventions to improve follow‐up are needed.

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“…12 No diagnoses of glaucoma were missed suggesting that although inaccuracies and disagreements exist, virtual assessment is a safe adjunct in glaucoma care. 13 A further example of community-based management of retinal diseases is the monitoring of retinal diseases, an incidental finding on routine fundal examination, which may be associated with an increased risk of choroidal melanoma.…”

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confidence: 99%

Smart Phone Based Teleophthalmological Services of MKCG McH, Berhampur

Mahapatro¹,

Dash²,

B³

2018

jebmh

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BACKGROUNDThe rural citizens who constitute major portion of Indian population are underprivileged as they have very little or no access to tertiary eye care. In order to make eye care services accessible to everyone, the concept called teleophthalmology has come into existence. A mobile van with eye-care-experts and equipment regularly reconnoiters through the rural population in the district of Ganjam to carry out screening, offsite diagnosis, monitoring, providing treatment and distantly educate the paramedics. The whole gamut of activities of this initiative can be categorized into three broad aspects. The first one is to screen out patients with treatable ailments and advise them for future course for a better prognosis. The second one is to educate the paramedics and ophthalmic assistants of their locality and generate consciousness among the mass. The third one is smartphone-based transmission of information of patients to the Prof. & Head and to other senior faculty of Department of Ophthalmology for treatment on the spot or to store information for use subsequently.

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Cambridge community Optometry Glaucoma Scheme

Abstract: The COGS community-based glaucoma screening programme is a safe and effective way of evaluating glaucoma referrals in the community and reducing false-positive referrals for glaucoma into the hospital system.

Cited by 46 publications

References 27 publications

A collaborative care pathway for patients with suspected angle closure glaucoma spectrum disease

A collaborative care pathway for patients with suspected angle closure glaucoma spectrum disease

Integrating opportunistic glaucoma screening into general health examinations in China: A pilot study

Smart Phone Based Teleophthalmological Services of MKCG McH, Berhampur

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