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A study to assess the quality of referrals from optometrists in north-east Scotland to the hospital glaucoma services has revealed a significant increase in true positives since the implementation of the new GOS contract in April 2006.

Researchers from the Department of Ophthalmology, NHS Grampian, Aberdeen Royal Infirmary looked at two six-month periods - one before the introduction of the new GOS contract (from June to November 2005) and the other after (from June to November 2006).

Researchers reviewed the community optometrist referral forms and compared them to the hospital glaucoma service notes.

In all, 183 referrals were made during the first period and 120 referrals were made during the second period.

According to the study, after the introduction of the new GOS contract there was a statistically significant increase in true positive referrals (from 18 per cent to 31.7 per cent), a decrease in false positive referrals (down from 36.6 per cent to 31.7 per cent) and an increase in the number of referrals with information on applanation tonometry (from 11.8 per cent to 50 per cent), dilated fundal examination (from 2.2 per cent to 24.2 per cent), and repeat visual fields (from 14.8 per cent to 28.3 per cent) when compared to the first six-month period.

However, only 41.7 per cent of referrals fulfilled the new GOS contract requirements, with information on applanation tonometry the most commonly missing.

In their conclusion, the authors said that despite a significant improvement in the quality of glaucoma referrals from the community optometrists in north-east Scotland, there was still scope for further improvement.

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