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The future of glaucoma clinics
  1. A M S Morley1,
  2. I Murdoch2
  1. 1Moorfields Eye Hospital, 162, City Road, London EC1V 2PD, UK
  2. 2Department of Epidemiology and Preventative Ophthalmology, Institute of Ophthalmology, 11-43 Bath Street, London, EC1V 9EL, UK
  1. Correspondence to: MsAna M S Morley MA, MRCOphth, Moorfields Eye Hospital, 162, City Road, London EC1V 2PD, UK; susie{at}morleys.net

Abstract

The number of patients seen with glaucoma related pathologies is predicted to increase significantly over the next few years as a result of an ageing population, increased optometric screening, and raised public awareness. In addition, the recent glaucoma literature proposes more aggressive management of ocular hypertension, open angle glaucoma, and narrow angle pathologies. This will overburden many glaucoma services and demands a reappraisal of current management strategies. Using a database of patients compiled from their tertiary referral glaucoma service as an example, the authors discuss the current controversies relating to each glaucoma subtype, encompassing issues relating to disease prognosis, efficacy of treatment, and resource management. They also suggest a range of strategies aimed at streamlining glaucoma clinics. Examples include shared care schemes, multidisciplinary teams, clinic guidelines/protocols, and alteration of clinic review times. The predicted effect of such schemes on clinic workloads is discussed, together with any existing validation.

  • ACG, angle closure glaucoma
  • BRVO, branch retinal vein occlusion
  • CRVO, central retinal vein occlusion
  • HRT, Heidelberg retina tomograph
  • HRVO, hemiretinal vein occlusion
  • IOP, intraocular pressure
  • NLES, North London Eye Study
  • OHT, ocular hypertension
  • PAC, primary angle closure
  • PACG, primary angle closure glaucoma
  • PI, peripheral iridotomy
  • POAG, primary open angle glaucoma
  • RTA, retinal thickness analyser
  • glaucoma
  • service
  • hypertension
  • shared care
  • ACG, angle closure glaucoma
  • BRVO, branch retinal vein occlusion
  • CRVO, central retinal vein occlusion
  • HRT, Heidelberg retina tomograph
  • HRVO, hemiretinal vein occlusion
  • IOP, intraocular pressure
  • NLES, North London Eye Study
  • OHT, ocular hypertension
  • PAC, primary angle closure
  • PACG, primary angle closure glaucoma
  • PI, peripheral iridotomy
  • POAG, primary open angle glaucoma
  • RTA, retinal thickness analyser
  • glaucoma
  • service
  • hypertension
  • shared care

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