Opinion

Bill Harvey: Dynamite with a laser beam

​There has been plenty of interest in the Lancet study published recently

There has been plenty of interest in the Lancet study published recently and to which I first referred last week.

To recap briefly, the LiGHT team based around Moorfields has published results that clearly demonstrate that not only is the SLT laser treatment for glaucoma as effective (if not more so) for lowering intraocular pressure than ongoing use of topical drugs, but the procedure is significantly more cost effective over the lifetime of a typical glaucoma or ocular hypertension patient (see page 25 for a comprehensive review of the technique and consideration of the implications of the new report).

Since last week, I have heard the views of several colleagues excited by the prospect of SLT superseding the use of drops where appropriate. Not only is this going to be better for the patient (have you ever met one who is happy using drops indefinitely?), but offers an opportunity for the profession.

There are already hospital optometrists undertaking SLT. The AOP has said its indemnity will cover IP optometrists undertaking SLT. And appropriate training courses for optometrists to use SLT are in development at centres like Moorfields. SLT treatment of glaucoma and OHT falls within the remit of the IP optometrist, and this makes the future roll-out of SLT in community practice a perfect model for the future of how a cost-effective eye health service within the community may be provided and so free up much need resources for use elsewhere.