Local NHS linked regular Glaucoma monitoring

[Monopost]

I have narrow angles, no glaucoma, have had iridotomies in both eyes and currently taking Monopost daily. I am now on 6/9 month check ups and my consultant mentioned that instead of treking to the main hospital eye unit I may be able to use one of the local opticians for this service under an 'NHS/optician agreement'. My GP doesn't know what I'm talking about, neither the local medical centre and Specsavers knew about it but they weren't currently offering the service. Does anyone know of a list anywhere that details opticians under this 'service' ?

[Trish_GlaucomaUK Partner]

Hello. I have just tried to look up info for you but have not been able to find out anything. I have heard of Community Glaucoma Networks in Kent where opticians work alongside the eye clinic to monitor the patient outside of the eye clinic. The best thing to do is to speak to opticians in your area to see if they are part of a similar scheme. It tends to be private opticians who offer this.

[Monopost in reply to Trish_GlaucomaUK]

Well I have just discovered that there is such a scheme run by CHEC (chec.uk/) but unfortunately nothing more local than the hospital so not helpful to me

[whitedog in reply to Monopost]

Are there any eye clinics attached to GP surgeries near you?

I'm now under two eye clinics at two hospitals. I asked at my last appointment if I could possibly be monitored at an eye clinic that is in the same building as a GP surgery close to me.

By co-incidence, the person I saw said she actually worked at that eye clinic but, as I was a complex case, I might need to still be seen at the hospitals for now - but it might be a possibility in the future.

[Monopost in reply to whitedog]

Thank you for your reply. We do have a small local hospital with a visiting ophthalmology team but they do not offer a monitoring service. I don’t really know why the NHS couldn’t have an arrangement with local opticians for this sort of thing - would surely free up the larger hospitals allowing better use of time for more complex cases. It really only takes 15 mins to do a peripheral vision test, a pressure test and imaging picture. There must be loads of patients like me who just need monitoring every few months - results can be sent on to the consultant who can arrange an appt if required.

[Mitziecat]

Hi. I have eye checks with Vision Express. In the past they have checked my eye pressure flowing an email from my consultant to request it. However, I think that has now changed as glaucoma monitoring and eye scans are now done under an additional payment.

[Lynne-H]

Scrivens Opticians may be a possibility if there`s one near to you.

[Monopost]

Tried Scrivens - can offer all those services as an optician but not part of a linked NHS monitoring service

[Sorshup in reply to Monopost]

This is complex. First, if there is a formalised optometric glaucoma system in your area your consultant should have directed you to it properly. Such schemes are funded either by the hospital or the local nhs and are not very remunerative; consequently it is usually the independent practices that get involved. Such schemes worry the ophthalmologists from the aspect of responsibility and accountability - who carries the can if you are considered to have had inadequate care? Hence few such schemes. And they don't understand that the NHS sight test cannot be used for disease monitoring ( though in reality your optom will be bearing it in mind at a consultation). But you can, of course request and pay for IOPs, fields and imaging, assuming your optom and you agree that he/she is assuming no responsibility beyond that of a technician and that how you use the information gained is up to you. But remember always to ask your consultant for your target pressures to compare with what is found at a sight test. Mind you, glaucoma may still progress despite this being maintained, so chasing the hospital for planned check ups is still important.

[Monopost in reply to Sorshup]

As I see it there is no responsibility on the local optician carrying out the tests as they are simply conducting the test on behalf of the consultant and sending him/her the results to review. The Consultant would then call the patient in if they need a further review. The optician would simply charge the NHS for carrying out the test. I suppose the only problem is being certain that the Consultant has indeed received the test results in the first place.

[Sorshup in reply to Monopost]

You are correct if that is the configuration of the scheme. But there is an independent prescribing qualification for optometrists and the scheeme could permit the optometrist to make a decision about the continuing treatment; this is where it gets tricky. "The optometrist would simply charge the NHS...." Oh, what innocence! The establishment of such schemes involves much bureaucracy and negotiation as well as fine detailed agreement on the clinical aspects! But the lack of progress with such schemes is frustrating for all.

[Supersec]

I was diagnosed with juvenile glaucoma over 50 years ago. I initially had surgery and was then on drops for many years. It was then decided I no longer needed the drops and during that period I was monitored by my own independent optometrist annually. However, following referral to the local eye hospital regarding another eye condition I was advised that I needed to restart drops. At that point my optometrist said that as I was on treatment he was unable to continue monitoring my glaucoma, although he does still check my IOPs and discs when I go for my glasses check which is now every two years. I now attend a Community Eye Clinic which is based in a Health Centre. This clinic is staffed by GPs with Special Interest in Ophthalmology and a visiting Consultant Ophthalmologist. Your optometrist should know if there is such a clinic near you. I do have to travel to this clinic but it is a much quieter clinic and preferrable to the local hospital.

[Monopost in reply to Supersec]

I think it depends on where you live then, we have a local community hospital with a visiting eye team but no monitoring services available. Seems my nearest option is still the General Hospital - a 50 min journey which is OK as I have a car but would be nice to have somewhere local just for a quick check up every 9 months. Hey ho I am still grateful for the care I am receiving.

[Supersec]

Oh dear that is a distance to travel. I suspect there must be a lot of people in your area with the same problem. I hope you can find a solution.

[Monopost in reply to Supersec]

Thank you for yr info