I examined her eyes and noted uncontrolled intraocular pressures and a worsening visual field. In response I changed her glaucoma eye drops and scheduled a review, but warned her that it would be delayed. Joan was upset to hear about this delay. On leaving, Joan made the suggestion that it would be helpful if patients had the choice of being seen closer to home to free-up space in the hospital.
Joan's glaucoma follow-up appointment had been three months overdue. It is not possible to know if she would have lost as much sight as she did if she had been seen on time, but certainly some patients with glaucoma are unnecessarily losing sight as a result of appointment delays. The traditional model of glaucoma services being provided exclusively in hospitals is falling short of the needs of many patients. Not only is it failing to meet demand, which has a visual cost for a few and causes anxiety in many, but for a sizeable number of patients it is an inconvenient and unpleasant experience. The situation for glaucoma patients seems likely to only get worse, as the demand for glaucoma services is expected to grow in the future as the number persons living to an older age increases.
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