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Glaucoma Referral Refinement

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By: NHS Grampian

Project Description

Background: Enhanced case finding is using health information and education about appropriate health-seeking behaviours when a patient experiences symptoms of a health condition (in this case, glaucoma). This can involve improving access to diagnostic services as well.

Approach: At NHS Grampian, the glaucoma laser clinic used enhanced case finding to streamline patient attendance at the hospital glaucoma service. Also, staff triaged patients with suspect primary angle closure directly for assessment, and where needed, laser iridotomy treatment. Ophthalmic specialist trainees were trained as part of this glaucoma referral refinement scheme.

Intended Benefits

Patient outcomes: By using enhanced case finding, more than 75% of patients referred by community optometrists with suspect narrow angles actually were at risk for angle closure. YAG peripheral iridotomies were carried out at the first appointment, which could reduce the discomfort and burden of patients.

Environmental, Financial, Social: An ophthalmic specialist trainee conducted the assessment, consent process, and procedure, which allows trainees to develop skills. Further research is needed to determine the exact environmental, financial, and social impact on improving detection and treatment of narrow angles; however, the system can be assumed to reduce financial costs of late diagnosis for patients.

Potential Barriers

Challenges to this project:

  • Training to correctly triage patients for angle closure

Key Aspects of the Project

This project considers the patient’s entry into care and how to improve the process to be more sustainable.

Aberdeen Royal Infirmary

Adnan Khan, n/a