Capacity in glaucoma care: The role of optometry and innovations in service delivery

Abstract

Background “The Way Forward: Glaucoma” (2016) highlighted the capacity crisis in glaucoma, recommending service planners considered developing referral filtering services, virtual clinics, and training optometrists to deliver glaucoma related care. The aim of this study is to investigate current services and the multistakeholder perspective of these recommendations to inform glaucoma services planners. Methods The false positive (FP) and negative (FN) referral rates within the Manchester Glaucoma Enhanced Referral Service (GERS) were evaluated. Clinical leads were surveyed, and a multistakeholder evaluation of perceptions of glaucoma virtual clinics conducted. A scope of practice survey of hospital optometrists was undertaken with a subsequent qualitative evaluation of the role of optometrists delivering glaucoma care. Results The Manchester GERS is an effective referral filtering service with low FP and FN rates. Glaucoma virtual clinics can be acceptable to both clinicians and patients, with a varied complexity of disease. The multi-stakeholder perspective affirms there is notable support for developing glaucoma services delivered by optometrists. Conclusion Use of referral filtering services, virtual clinics, and specialty trained optometrists should be considered by providers of glaucoma related care, as they can increase capacity and improve the quality of care. Success in developing services is reliant on multi-stakeholder input, investment in technology and training, inter-professional respect and appropriate time and funding to set up and deliver services.

Date of Award	1 Aug 2024
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Chris Dickinson (Supervisor) & Robert Harper (Supervisor)