Review of the glaucoma care pathway

Stephen Vernon explains the development of the glaucoma care pathway, which aims to take the care of glaucoma suspects away from the HES and into the community

In January 2003, I was invited to join the then recently formed Eye Care Services Steering Group of the Department of Health as chair of the Glaucoma Care Pathways Working Party. We were given a brief to examine the current system of glaucoma care in the UK and make recommendations for change with a view to the future, both near and distant.

The working party consisted of 10 members, four ophthalmologists (including myself and the president of the Royal College of Ophthalmologists), a general practitioner and five optometrists and dispensing opticians. Initially, in conjunction with the other working parties, we were given a very tight timetable to work to, but the complexity of the task quickly became evident and the deadline moved from a few weeks to a few months.

In view of the impossible logistics involved in getting the working party together, it was agreed that we would work by email, with members making comments on drafts compiled by myself. Knowing that the final document was draft 9 will give the reader an idea of the interaction that ensued.

Having been an early pioneer of shared care in glaucoma within the Hospital Eye Service (HES), with 10 years' experience of the issues involved and with a long-standing research interest in glaucoma detection, I was confident that we could suggest significant improvements to the current care pathway. These improvements would aim to move the care of glaucoma suspects and eventually many individuals with glaucoma away from the HES and into the community.