Making sense of the recent glaucoma related NICE guidelines

Professor Stephen Vernon clarifies the implications of the NICE guidelines on glaucoma for the primary care optometrist

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In April 2009 The National Institute of Clinical Excellence (NICE) issued guidance concerning the diagnosis and management of chronic open-angle glaucoma (COAG) and ocular hypertension (OHT) (see Further reading). Prior to this, community optometrists had been referring glaucoma suspects based upon guidance from the General Optical Council, the College of Optometrists and sometimes their local ophthalmologists. In relation to lower risk OHT, guidance from the GOC about 11 years ago permitted optometrists to observe such cases without referral. Indeed, those of us working in the Hospital Eye Service (HES) noted a reduction in referral of cases of OHT compared with the levels of referral in the 1990s.

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