Glaucoma guidelines of questionable benefit

NICE guidelines for glaucoma diagnosis and management have resulted in more patients referred but no increase in the absolute numbers of glaucoma and glaucoma suspects identified.

A study looked at optometrist initiated referrals for suspect glaucoma and ocular hypertension to the Moorfields Community Eye Clinic at Ealing Hospital over a two-month period some six months after the publication of the NICE guidelines. Each referral was then classified as either glaucoma negative, ocular hypertensive requiring further follow-up in the hospital, ocular hypertensive to be followed up by the community optometrist, or 'other'.

The positive predictive value (PPV) was then calculated and compared with historical values from previous studies. Overall there were 110 new referrals, which suggested a significant increase from previous tallies (eg 69 in 2002, 41 in 1999).