Tool cuts unneeded glaucoma referrals

A device that detects signs of glaucoma cuts unnecessary referral for eye problems, UK research shows.

The use of Goldmann applanation tonometer (GAT) reduces unneeded referrals for suspected glaucoma by two thirds, according to researchers at the Royal Eye Infirmary in Plymouth.

Referrals for suspected glaucoma have increased substantially, putting strain on hospital eye services and raising costs.

GAT, recommended by NICE as a ‘gold standard’, more accurately records intraocular pressure, a symptom of glaucoma.

But it is often deemed too expensive by community optometrists who use other tonometry devices that can overestimate measurements, leading to inappropriate referrals.

In a pilot study over five months, researchers used GAT to assess people with high intraocular pressures as measured by other tonometers but with no other symptoms of glaucoma.

Out of 3,295 people assessed during this time, 73 (2.2%) had a high intraocular pressure of over 22.

They would normally have been referred to the hospital eye service for further tests.

But when the assessment was repeated using GAT, almost two thirds of this group (46) had intraocular pressures of 21 or below, and so did not need to be referred.

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