High intraocular pressures detected with a non-contact tonometer (NCT) should be repeated with a Goldmann tonometer before referral but only if the service is appropriately funded according to the Association of Optometrists.
The AOP was responding to reports on a Plymouth based study (News 05.11.10) that use of NCT readings for referral by optometrists were wasting primary care trust funds and causing patient distress.
In a letter to be published in Optician next week the Trevor Warburton, clinical adviser, AOP legal services, said false positives could easily be reduced by a back-up scheme but funding had to be in place.
He pointed to the experience in his own area where 77 per cent of potential referrals were deflected by a funded scheme for repeat pressures. Such schemes were highly cost effective he wrote. 'What staggers me is how long it is taking some [PCTs] to implement it, and how complicated some of them manage to make a very simple process.'
He rejected the idea that the whole profession should move to contact tonometry unless it was funded by primary care trusts. Warburton suggested that the NCT was a much maligned instrument and the problem of excessive referrals had been fomented by the change in guidelines by the National Institute for Health and Clinical Excellence.
Since the introduction of NCTs the optical profession had voluntarily invested in NCTs and patients had enjoyed the benefit but this had never been recognised by government with funding or thanks.
? The College of Optometrists was due to discuss its response to the reports from the Plymouth study as Optician went to press.