- You must carry out relevant tests when examining a patient who is in an at-risk group for glaucoma.
- Those with a greater than average risk include certain ethnic groups, patients with first degree relatives with glaucoma and those over 40.
- In England, patients whose IOP is 24mmHg or greater should be treated.
- You should follow local protocols if you are participating in community services.
References
87 Sight Testing (Examination and Prescription)(No 2) Regulations 1989 para 3(1)(a) [Accessed 19 Nov 2020]88 National Institute for Health and Care Excellence (2017) Glaucoma: diagnosis and management [Accessed 19 Nov 2020]
89 The College of Optometrists (2017), NICE Guideline – Glaucoma diagnosis and management (update) [Accessed 25 July 2019]
90 Scottish Intercollegiate Guidelines Network (2015) Glaucoma Referral and Safe Discharge [Accessed 19 Nov 2020]
- optic disc features suggestive of glaucoma
- loss of peripheral vision
- high IOP.
- in certain ethnic groups, for example African-Caribbean people
- with first degree relatives with glaucoma
- over the age of 40. The risk increases with every decade of life thereafter
- with thinner corneas
- with myopia (myopia >6D is associated with an increased risk)
- with diabetes
- with systemic hypertension
- taking topical or systemic steroids, as they may develop steroid-induced glaucoma.
References
91 College of Optometrists (2018) Clinical Management Guidelines Primary Open Angle Glaucoma [Accessed 19 Nov 2020]- formally diagnosed with ocular hypertension by a healthcare practitioner who has appropriate training or qualifications
- treated, as they are at greater risk of developing glaucoma
References
92 Shah R, Wormald R (2011) Glaucoma. BMJ Clinical Evidence (online) [Accessed 19 Nov 2020]93 National Institute for Health and Care Excellence (2017) Glaucoma: diagnosis and management NG81 [Accessed 19 Nov 2020]
- assess the optic nerve head. This would include assessing the size of the disc
- measure the IOP. See paragraph A239.
References
93 National Institute for Health and Care Excellence (2017) Glaucoma: diagnosis and management NG81 [Accessed 19 Nov 2020]Blakeney S (2017). Glaucoma and ocular hypertension – NICE guidelines, past and present Optometry in Practice 18(4):218-224 [Accessed 19 Nov 2020]
The College of Optometrists. Clinical Management Guidelines [Accessed 19 Nov 2020]
College of Optometrists higher qualifications in glaucoma [Accessed19 Nov 2020]
Eye Health Examination Wales clinical manual with protocols for optometrists, ophthalmic medical practitioners (OMPs) and contractors (2018) [Accessed 19 Nov 2020]
International Glaucoma Association [Accessed 19 Nov 2020]
National Institute for Health and Care Excellence (2017) NG81: Glaucoma: diagnosis and management [Accessed 19 Nov 2020]
Royal College of Ophthalmologists (2016) Commissioning Guide: Glaucoma [Accessed 25 Nov 2020]
Scottish Intercollegiate Guidelines Network (2015). SIGN 144. Glaucoma referral and safe discharge [Accessed 25 Nov 2020]