“Detection and management could, or should, increasingly fall under the care of optometrists”

The clinics are based in community health centres and see patients referred by GPs or fellow optometrists to determine whether they have glaucoma and if they require intervention. If so, then we can initiate treatment.

I work with three other optometrists under the guidance of a glaucoma consultant and between us we will see between 20 and 25 patients a day. We also work with a clinical technician who undertakes the admin and carried out visual fields.

For patients, the clinic means their care is local and easier to access. A patient can typically be in and out within an hour, whereas hospital eye services can be a three-four hour wait.

I started doing the clinic because it let me use a broader skillset within a specialty setting. It is quite different to what I am doing on a day-to-day basis. I keep doing it because I like the people I work with and enjoy serving this particular population, which is different to the needs of the patients I see regularly in practice.

For patients, the clinic means their care is local and easier to access

Inspired to go further

After graduating from City, University of London (now City St George’s, University of London) in 1999, I practised in a multiple, then a smaller regional, and became a bit bored with that type of practice.

I was considering moving to the US, which required me to complete a conversation course to practice optometry. This exposed me to the increased scope of practice of our US colleagues and when I returned to the UK, I looked to emulate that. I worked at St Thomas’ in the glaucoma services and whilst there I completed my professional diploma in glaucoma.

Technically, most of the skillset required to assess glaucoma patients are core competencies in the UK. In the US, I had training in all the required skillsets and was gaining experience.

As I have a diploma in glaucoma, and a diploma in therapeutics, the level of care, diagnosis and management will be impacted by this, as stated by guidelines from the National Institute for Health and Care Excellence.

I would like to achieve accreditation in selective laser trabeculoplasty application to offer increased treatment options.

Supporting ophthalmology services

Most optometrists leave university with most of the skillset and knowledge to provide this level of care. Experience and additional qualifications are invaluable in allowing you to provide fantastic care in the community.

Patients like to be seen locally. Being able to provide local services by appropriately trained eye care professionals, who are appropriately renumerated, should be the goal for all the integrated care boards in England.

Glaucoma patients are long-term, chronic patients. Once in the system, they are more often than not here for the rest of their lives. With an ageing population, this is an increasing burden on ophthalmology services.

There are significantly more optometrists than ophthalmologists, and we already have most of the core skills to assess glaucoma patients. Many also have hospital grade technology in practice. These practitioners could be utilised to manage the increasing burden of glaucoma patients.

In a perfect world, I would like to see community optometry services able to offer everything for glaucoma patients short of what would be needed in a surgical suite.