None listed
Conditions
Brief summary
In Australia ~75% of eye examinations are delivered by Optometrists. Optometrists have a legal and moral obligation to identify eye disease, manage suitable cases and refer others requiring medical or surgical intervention to ophthalmologists. With an aging population, the management of chronic eye disease is an increasing issue for the already stretched health system. The NHMRC glaucoma guidelines encourage development of shared-care models between primary health care providers and ophthalmologists. The guidelines also highlight the need for low-risk glaucoma patients to be monitored by primary eye care providers and not referred to Ophthalmology thereby minimizing the possibility that the health system is overloaded with false positive referrals. Until now, this new model of glaucoma management has been largely unexplored, especially with regards to assessing the effectiveness of the current optometric profession in clinical diagnosis, referral quality, appropriately utilization of new technologies and integrating with complementary facilities and services. The Centre for Eye Health (CFEH), a joint Guide Dogs NSW/ACT and UNSW initiative is leading the way in promoting a shared care model for eye-care in Australia. Ophthalmic practitioners refer patients to CFEH for visual assessment using the latest technology. Over 830 optometrists in NSW/ACT have registered with CFEH. It is proposed that this pool of participants be analysed with regards to current glaucoma practice characteristics, effectiveness in clinical diagnosis, referral quality, appropriate utilisation of new technologies and integration with complementary facilities and services. The research will inform current models of Glaucoma management and the evidence will have direct policy implications for the regulatory partners. Ultimately, more cohesive and patient-focused service delivery will lead to improved quality of life for patients and a reduced economic burden of eye disease nationally.
Interventions
Patients at risk, suspects or monitored for glaucoma will be followed over a 5 year period. Biannual exams as recommended by the "NHMRC guidelines for the screening, prognosis, diagnosis, management and prevention of glaucoma 2010" will be performed and results will be compared to an age-related control group. Exams include patient history, refraction, slit lamp exam, visual field test (SAP), Gonioscopy, Pachymetry, OCT scan, HRT, and optic disc photography.
Sponsors
Prof Michael Kalloniatis
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
Inclusion criteria: 18-80 year, gonioscopically open angles, IOP below 32 in either eye, normal optic disc at initial clinical examination and on stereoscopic photographs as determined by the two independent ophthalmologists with specialty in glaucoma, 2 normal and reliable visual field tests per eye at initial examination as determined by the two independent ophthalmologists with specialty in glaucoma.
Exclusion criteria
Glaucoma other than primary open angle glaucoma, previous intraocular surgery (other than uncomplicated cataract extraction with posterior chamber lens implantation), and any disases capable of causing visual field loss or optic disc deterioration.
Outcome results
None listed