1. Glaucoma Services
Northern Ireland

2. NICE Glaucoma
Diagnosis and management of chronic open angle glaucoma and ocular hypertension

3. Introduction

4. Estimated 25 - 40% outpatient visits are glaucoma related
The glaucoma problem
Estimated % outpatient visits are glaucoma related
Massive rising demand dictates that low complexity work be shifted into the community where it is more feasible

5. Diagnosis, OHT, Suspect, COAG

6. Service Provision

7. Recommendation

8. The platform

9. AOP, ABDO, FODO
Strongly advised to refer all patients with IOP > 21 mmHg, regardless of instrument

10. False Negative

11. Current Provision 2 glaucoma clinics per week in Belfast
Hospital shared care, optom & 2 nurse specialists
Less than half visual field capacity
One imaging device
Reviews often one year behind

12. Current Equipment Expensive imaging requiring trained personnel
Inability to purchase equipment
Not used appropriately as system too stressed

13. Interventional Provision
At least 2 surgical glaucoma cases per week
Require 4 – 25 consults in 1st month
Consultant intensive

14. Notes, records, reviews, RVH
No notes
90 % notes chronologically inaccurate
Abysmal

15. Shared Care Team required
Large numbers patients seen by glaucoma capable personnel
Access to consultant
Appropriate visual fields and imaging immediately available
Glaucoma lifelong