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Great expectations

A 15-minute laser treatment could replace the inconvenience of daily drops for glaucoma patients

14 Mar 2019 by Selina Powell

Covering science and vision stories for OT , there are many press releases that come across my desk that sound promising, but the potential for the device or treatment to transform the daily lives of patients is slim and may not occur for many years.

In most cases, further testing needs to be conducted, funding needs to be secured and flaws in prototype models need to be ironed out.

A study published in The Lancet by Moorfields Eye Hospital and the UCL Institute of Ophthalmology researchers is an example of research that has more tangible implications for patients facing sight loss as a result of disease.

The research finds that a laser-based treatment, selective laser trabeculoplasty (SLT), may be more effective in the treatment of glaucoma than the traditional treatment of eye drops.

This approach would have many benefits – there would be fewer compliance challenges in getting patients to administer daily drops and the one-off 15-minute treatment could help to alleviate the burden of disease in developing countries.

Cost is another big factor. Substituting SLT for drops would enable the stretched NHS to save the NHS £1.5 million per year in treatment costs for newly diagnosed patients, with potential to save the health service £250 million per year if the treatment proves to be as effective in previously diagnosed patients.

A commitment to improving the care of patients through research and innovation has seen Moorfields receive a glowing endorsement from the Care and Quality Commission this week. All of the services assessed were rated either “good” or “outstanding” following an inspection in November last year.

In addition to high-level research conducted by universities and hospitals, optometry practices can improve the care of their patients by continuing to question the treatments on offer and the processes staff follow.

Always being willing to ask, ‘what if?’ stands all professionals in good stead. We are keen to hear how you have applied innovation in practice – email us

Image credit: Getty


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Comments (5)

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    Nicholas Rumney

    So far as we are aware AOP indemnity is provided at the level that covers what is within the scope of practice for an optometrist. So as SLT is being performed by optometrists along with YAG, PCO & PI it should be fine. A definitive statement that this the case for those appropriately trained is now clearly needed. This truly is an enhanced service unlike MECS or similar which is basically entry level competence with accreditation.
    Taken in context with the RCOphth workforce survey showing a desperate lack of capacity this is part of our present, not just our future.

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    John Gurney

    Those Specialist Glaucoma/IP Optometrists who manage glaucoma independently in the community need to be offering and performing this treatment as part of there management arsenal.
    AOP need to support and provide professional indemnity to meet this aim, I trust this will be forthcoming

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    We have been using SLT in our hospital glaucoma clinics for some years now, with variable results. Success rate for achieving target IOP with or without continuing topical therapy is around a maximum 70% of treated patients, with a definite diminution in effect over time, although repeat treatments are offered as required. The LIGHT trial will hopefully bring some insights into the efficacy of SLT vs topical therapy when results become available soon.

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    IP optometrists with glaucoma qualifications should now be queuing up to get SLT trained. There is a tsunami of patients with glaucoma that must not be denied this treatment. I am delighted that the AOP is supportive of optometrists stepping up to provide SLT to their patients

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    Don Williams

    This is exciting news! I am due to having my SLT training, including further YAG Capsulotomy training in June. I do not think it is a service that I will offer in my practice, at least not yet but definitely in the hospital setting where I work. I am lucky in a way to be working (and have been for many years) with some 'optom friendly' Consultants who are always pushing me to do more.

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