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The following is a summary of “Post COVID glaucoma service redesign utilising electronic patient triage and community optometry clinics (Fife, Scotland 2020—2022),” published in the January 2025 issue of Ophthalmology by Nalagatla et al.
Researchers conducted a retrospective study to define the redesign of a glaucoma service using electronic patient triage and the Scottish optometry infrastructure with upskilled optometrists to address the COVID-19 backlog.
They identified 2,276 patients in glaucoma clinics, triaged into 3 levels following the Glauc-strat-fast guidance with local amendments. Patient details, including demographics, clinical findings, and social deprivation scores, were entered into a customized glaucoma database. The database automatically generated letters for patients, GPs, and optometrists. Level 1 (482 patients) were discharged under the Scottish general optometry service contract. Level 2 (714 patients) were discharged to glaucoma-accredited community optometry clinics, with decisions discussed weekly through screen-sharing with glaucoma consultants. Level 3 (1,080 patients) were retained in the hospital. Outcomes were audited and analyzed 24 months after service implementation.
The results showed statistically significant differences between the 3 groups, with level 1 patients having more normal eyes, lower mean deviation on visual fields, and less social deprivation. After 24 months, 40.2% of level 1 patients returned, primarily for other diseases, with only 20.4% remaining in the hospital or at level 2. Among level 2 patients, 9.4% returned to the hospital, and only 2.7% remained in the hospital at 24 months.
Investigators concluded that patients with glaucoma in Scotland could be effectively triaged to community optometry clinics, thereby increasing hospital capacity to treat patients with more severe disease and improve visual outcomes.
Source: bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-025-03882-7
