23 October 2019

Response to consultation on screening for glaucoma

We have responded to the UK National Screening Committee's consultation on glaucoma.

Recommendations on screening

The College of Optometrists agrees with the conclusion of the National Screening Committee; the College agrees that open-angle glaucoma is a condition that does not meet the required criteria for a population screening programme. Notwithstanding that, glaucoma is a condition which is detected opportunistically by primary care optometrists during a sight test. Furthermore, at-risk populations may choose to have a sight test funded by the NHS, specifically to detect early signs of open-angle glaucoma. 

Primary care optometrists are able to synthesise the information from a range of tests to detect open-angle glaucoma, which always includes tonometry, optic nerve head assessment and visual fields. Increasing numbers of optometrists are using advanced imaging, pachymetry and gonioscopy in practice and have undertaken additional training to develop a specialist interest in the disease.  The lack of evidence surrounding the benefit of a population-based screening programme should not detract from the sight-saving work done by optometrists in opportunistic case finding for open-angle glaucoma which is, in its early stages, asymptomatic. 

Submitted: October 2019

Related further reading

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In this article three interesting glaucoma cases are discussed alongside the evidence-based approach underpinning management decisions.