NICE Guidelines
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:
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