Optometric assessment and decisions regarding primary angle closure
Research type
Research Study
Full title
Evaluation of clinical decisions and assessment of those at risk of primary angle closure by community optometrists
IRAS ID
315329
Contact name
Anish Jindal
Contact email
Sponsor organisation
Moorfields Eye Hospital NHS Foundation Trust
Duration of Study in the UK
0 years, 11 months, 31 days
Research summary
Increases in the aging population has resulted in increased demand for glaucoma services. Glaucoma is a disease that if untreated, can lead to blindness. This increase and need for long term treatment with monitoring have resulted in a significant demand in the hospital eye service (HES). Many departments are now facing a considerable backlog of outpatient appointments and it’s essential that these appointments are reserved for patients who are at risk of glaucoma blindness.
Primary angle closure (PAC) glaucoma is a type of glaucoma, where the drainage route for the fluid inside the eye (known as the angle) is narrowed or blocked. It has been recently identified that approximately half of patients referred into the HES for a suspect narrow angle for further investigation are healthy and are immediately discharged. The exact reasons for these findings are unknown.
This project will investigate clinical decisions by community optometrists who account for the majority of PAC referrals into the HES, as well as assessing their ability to evaluate those at risk of PAC. This project will also examine whether clinical agreement could be improved by providing an educational package.A clinical image database of angles will be acquired from glaucoma patients attending Moorfields Eye Hospital. Clinical vignettes for an assessment will then be drafted using these images and be submitted to the REC & HRA via an amendment for approval. A learning package discussing angle closure referral will also be developed. Community optometrists will be invited to complete a questionnaire on their clinical decision making. This will be followed by the vignette assessment, learning package and re-assessment.
If this educational package and/or any other identifiers are found to improve agreement levels, this could reduce the number of referrals and enable community monitoring of those at low risk of developing PAC glaucoma in their lifetime.
REC name
East of England - Essex Research Ethics Committee
REC reference
22/EE/0172
Date of REC Opinion
27 Jul 2022
REC opinion
Favourable Opinion