Moneo writes: Life-changing guidance comes at a cost

Within a short space of time NICE has issued new guidance on both cataracts and glaucoma. Both these sets of guidance potentially have a profound effect on daily practice life. Looking at the glaucoma guidelines they now make it very clear that routinely, prior to referral, optometrists will be required to do far more checking than currently.

We will be expected, before referral, to offer central visual field assessment using standard automated perimetry using either full threshold or supra threshold methods, optic nerve assessment and fundus examination using stereoscopic slit lamp biomicroscopy and OCT or optic nerve head image if available, IOP measurement using Goldmann type applanation tonometry and peripheral anterior chamber configuration and depth assessments using gonioscopy or, if not available, or patient prefers, the Van Herick test or OCT.