NICE updates advice on glaucoma referral

Inappropriate referrals for investigation of raised intraocular pressure (IOP) are the target of a guide to support those commissioning services for patients at risk of glaucoma in England.

The updated guide, issued by the National Institute for Health and Clinical Excellence (NICE), looks at the commissioning of services for the referral, diagnosis and monitoring of patients at risk. NICE defines these as people with ocular hypertension and people with suspected chronic open-angle glaucoma (COAG).

The guide supports NICE's quality standard for glaucoma which it said would be 'expected to contribute to a reduction in Certificate of Visual Impairment registration rates for glaucoma'. The standard recommends repeat testing using Goldmann applanation tonometry for those with initial IOP over 21mmHg before referral to hospital.