People at low risk of glaucoma can avoid unnecessary referral

NICE has published an updated guideline on glaucoma, which will mean fewer people need to be referred for further specialist investigation and possible treatment.

The new guideline now includes a section on what tests should be carried out by primary eye care professionals to determine if referral to a specialist is necessary.

The updated guideline recommends a higher inner eye pressure threshold of 24mm/Hg to prompt referral and treatment. This is a change from the current practice of referring patients with an inner eye pressure of over 21 mm/Hg. It is now recommended that people with an inner eye pressure below 24mm/Hg should continue regular visits to their primary eye care professional so any future increase in pressure - a major risk for developing chronic open angle glaucoma (COAG) - is detected.

Mark Baker, director of the centre for guidelines at NICE, said: “Chronic open angle glaucoma is a condition that should be taken seriously. People at risk of the condition should be carefully monitored so that it can be treated early.

“Approximately 1.8 million people in the UK have an inner eye pressure of 22 or 23 mm/Hg. That puts a huge demand on secondary care eye services for patients who don’t need immediate treatment. Having a clear referral and treatment pathway to identify patients with ocular hypertension and suspected COAG ensures patients are assessed and treated in the most appropriate setting.

“Increasing the treatment threshold will not only lead to fewer patients being referred unnecessarily but it should reduce costs without compromising patient safety.”