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Outcome of referrals for suspected glaucoma
Author(s) -
Harper Robert,
Reeves Barnaby,
Hill Adrian
Publication year - 1995
Publication title -
ophthalmic and physiological optics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.147
H-Index - 66
eISSN - 1475-1313
pISSN - 0275-5408
DOI - 10.1046/j.1475-1313.1995.9593524p.x
Subject(s) - glaucoma , medicine , visual field , intraocular pressure , referral , optometry , ocular hypertension , ophthalmology , optic disc , gonioscopy , false positive paradox , family medicine , machine learning , computer science
Summary The source, content and accuracy of 178 referrals to Oxford Eye Hospital for suspected glaucoma were examined. The majority (82.6%) of referrals for suspected glaucoma were initiated by optometrists, other referrals being initiated by general practitioners (10.1%) and ophthalmic medical practitioners (7.3%). Most referrals (86.5%) reported the intraocular pressure (IOP) level. Comments on the optic disc were recorded in 53.9% of referrals. Only 21.3% of referrals mentioned the status of the visual field. The findings of all three ‘standard’ glaucome measures (i.e. IOP and the status of the optic disc and visual field) were reported in only 15.2% of referrals. A visual field defect consistent with glaucoma was found in 38.2% of referrals and a further 9.6% of referrals were prescribed treatment for glaucoma/ocular hypertension but had no manifest visual field defect. Approximately one‐third of referrals (34.2%) were considered ‘normal’ and were discharged. The remainder of referrals were either followed up as glaucoma suspects (9.6%) or were considered ‘abnormal’ but non‐glaucomatous (8.4%). There was evidence to suggest that (1) optometric referrals were more accurate than referrals from GPs and OMPs; and (2) referrals combining information from all three standard screening measures were more accurate than those based on IOP alone. These findings support previous surveys by the International Glaucoma Association. At least one‐third of referrals for suspected glaucoma are false positives. Visual field screening appears to be used very infrequently by primary vision carers suggesting that the false negative rate may also be high.