The National Institute for Health and Care Excellence (NICE) has published guidelines in November 2017 for diagnosis and management of glaucoma in individuals aged 18 years and over.
The guidelines include the following recommendations:
1. Case finding: These recommendations are targeted to primary eye-care professionals in order to detect cases and refer them to specialists for further management.
2. Diagnosis: This is based on certain tests such as visual field, optic nerve and anterior chamber angle assessments, as well as measurements of intra-ocular pressure and central corneal thickness.
3. Standard practice for all assessments: Records pertaining to previous tests, images, past medical history, glaucoma medication record, current medications and drug allergies and intolerances should be accessed. The machines and instruments for the tests should be regularly calibrated and maintained as per manufacturer specifications.
4. Reassessment: Certain examinations and tests have to be repeated on each visit for confirmation or monitoring.
5. Treatment: When management decisions are to be undertaken, the healthcare professional should take into account any cognitive and physical impairment, relevant co-morbidities or potential drug interactions.
6. Organization of care: Glaucoma suspects should be referred to specialists for confirmation of the condition. The healthcare professionals should understand the principles of diagnosis of ocular hypertension and chronic open angle glaucoma and be able to perform and interpret the previously mentioned tests and procedures. A management plan should be established.
7. Providing information: The individuals who come for glaucoma assessment should be offered the opportunity to discuss their diagnosis, referral, prognosis, treatment and discharge and provide them with relevant information in an accessible format at initial and subsequent visits.
THE NICE GUIDELINES ARE AVAILABLE AT THE FOLLOWING LINK AND CAN BE DOWNLOADED FROM THE WEBSITE: