World Glaucoma Week: tips for optometrists to enhance glaucoma care

Community optometry plays a vital role in supporting glaucoma patients, says glaucoma specialist Bhavik Parmar, a lead clinical performance consultant at Specsavers.

Here, he provides advice for optometrists to develop their community services to enhance patient care and reduce the burden on NHS hospitals.

Empowering optometrists to make a difference  

Equipping optometrists with the necessary skills to manage glaucoma effectively is vital. This includes completing WOPEC Glaucoma Level 2 course or in the devolved nations their equivalent training as required to provide local services. 

England: 

Having at least two optometrists per practice with a Professional Certificate in Glaucoma is crucial to deliver both Glaucoma Repeat Readings (GRR) and Glaucoma Enhanced Referral (GERS) services proficiently on behalf of the NHS in England, where they are commissioned locally. 

This certification, which takes three to six months to complete, provides the foundational skills needed to deliver both services. It also demonstrates that you as an optometry, practice owner and the wider sector can demonstrate we are ready and able to deliver such services where they’re not commissioned.

Wales: 

Following the Welsh GOS reform, under WGOS 4, there is a glaucoma refinement and monitoring service in Wales. This requires either a Prof Cert Glaucoma or High Cert Glaucoma to deliver. Optometrists must also complete WGOS 4 mandatory training. 

Scotland:

There is a glaucoma repeat readings programme as part of Scotland’s GOS Supplementary service.  There is also a Community Glaucoma Service in some Health Boards where the optometrists with IP and who have completed the NESGAT training can deliver this monitoring service. 

Northern Ireland: 

For Northern Ireland, for the Level II ES - Glaucoma Case finding, optometrists require Prof Cert Glaucoma and to complete glaucoma accredited CPD annually.  

Maximising the use of commissioned services 

For practices with commissioned glaucoma services, use these services to their full potential. It is rewarding because it provides care closer to home for patients. 

This includes conducting accurate eye pressure measurements using contact tonometry, which reduces false positives, and performing in-depth visual field tests and Optical Coherence Tomography (OCT) scans. 

By doing so, we can ensure that patients receive the most accurate diagnoses and appropriate referrals, ultimately improving patient outcomes and reducing the strain on secondary care.

Promoting awareness and engagement 

Raising awareness about the available glaucoma services is another critical aspect. Community optometrists should actively promote these services to patients, GPs, and pharmacists.  

This not only helps in managing glaucoma more effectively but also attracts more patients to the practice. Local marketing efforts, such as social media posts and community events, can play a significant role in spreading the word. 

Addressing a myth 

One common misconception is that repeat readings are time-consuming. In reality, these tests can be seamlessly integrated into regular clinic appointments and take only a few minutes to perform. Regular practice of these techniques ensures proficiency and efficiency, making it a valuable addition to patient care. 

A collaborative effort 

Together, we can make a significant difference in the lives of glaucoma patients. By empowering optometrists with training, delivering NHS commissioned community glaucoma services and advocating for an expansion of these and promoting public awareness of glaucoma.