I’ve been privileged to be part of several new glaucoma services, both as a clinician in my practices in Wales and as a facilitator and enabler as director of professional advancement for Specsavers. These have been in ophthalmology and optometry, though I think services are best when pathways are combined. The profession has progressed further than I imagined possible in the 20 years since I qualified. The role of an optometrist in the detection and management of this group of diseases has changed significantly and I believe there is huge unfulfilled potential for us to be part of the solution. Clinicians who have heard me speak over the years (thanks for not nodding off) will know I have a catchphrase when it comes to self-development: ‘Be selfish’ – what I mean by that will become clear later.

It is Glaucoma Awareness Week at the end of this month, an annual awareness-raising opportunity coordinated by the charity Glaucoma UK. Specsavers is taking part in the activities and supporting Glaucoma UK’s work to encourage people across the UK to talk about glaucoma and attend regular eye tests. In our 2021 Eye Health report (visit bit.ly/39dO0sh), we highlighted the 1.39 million people living with ocular hypertension and the further 708,000 living with glaucoma in the UK, which is likely to increase by 18% during the next 10 years. We can already see from our internal clinical outcome reporting that 12% of referrals are glaucoma-related. As our population ages and detection increases, our urgent duty is to save sight. We know that early detection followed by careful observation and regular treatment can usually minimise loss of vision. That’s why working together to tackle the backlog of patients is so important.

The College of Optometrists and the Royal College of Ophthalmologists recently published new guidance that maps clinical training to glaucoma patient pathways (visit bit.ly/3PWhyvf). This guidance supports a multidisciplinary workforce and promotes the role of local optometrists in glaucoma care. It aims to empower optometrists with specified qualifications to manage patients in different glaucoma risk categories within their primary care settings.

To tackle the issue of glaucoma care in our communities, clinicians need to protect time to develop themselves using the higher qualifications available and by gaining exposure to patients in ophthalmology and shared clinics. I’m very happy and proud that we’ve been able to fund these kinds of development opportunities and invest in our clinicians.

I heard about a great example of this in Specsavers St Albans, where we are supporting three optometrists at different stages in their career, including optometry partner Ali Hashim, to complete their Professional Certificate in Glaucoma. This qualification prepares practitioners to participate in formal enhanced case finding programmes and ocular hypertension or suspect chronic open angle glaucoma monitoring schemes. To understand the benefits of a clinical team working together on their professional development, I spoke with Hashim and the team.

All agreed that enrolling in the course at the same time has added benefits, including being able to discuss case studies, practise new skills together and test each other’s knowledge regularly. They have enjoyed opportunities to polish testing techniques, such as Van Herick angles and Goldmann Applanation Tonometry (GAT), and all have gained a better understanding of the data and indices displayed in visual field testing.

Colleagues have been very supportive as they have needed time out for teaching, studying and exams. Some even offered their eyes for GAT practise, which was really appreciated as this is not a test regularly performed at this location, given the demographic. Through the training, the team developed a new understanding of the importance of OCT in glaucoma monitoring. They cascaded this information down to colleagues, who can now explain to patients why OCT scans are important.

I asked if any of the optometrists have adapted or changed their clinical practise since starting the course. ‘Absolutely,’ they all said, particularly with reference to the use of OCT scan results. Noticing small changes when comparing the optic disc scans for patients over time is just one example. As management of glaucoma is tailored to each patient, the team has applied their learning to test and develop different approaches to detection and managing suspect cases. All agreed that their clinical practise has become more efficient as they have developed expertise in how to differentiate between different types of glaucoma.

Of course, there are thousands of other great examples in different practices up and down the country. I suppose the message is – whatever point you have reached in your career, the need for constant development remains, and there are plenty of colleagues and peers to support you. CPD is a tremendous opportunity to kick-start your ‘selfishness’ and, in this regard, it is no bad thing.

I could write tomes about the commissioning structure in England and how greater things could be achieved if it were more joined up as seen in devolved nations, but maybe another time.

  • Paul Morris is director of professional advancement at Specsavers UK & ROI .