THE SIGHT TEST FEE - EFFECT ON OPHTHALMOLOGY REFERRALS AND RATE OF GLAUCOMA DETECTION

Objective-To assess changes, if any, in the numbers of referrals and o utcome of glaucoma referrals to the hospital eye service since the int roduction of the sight test fee on 1 April 1989. Design-Review of refe rral records and clinical notes. Setting-Referrals to the Bristol Eye Hospital. Subjects-51 919 patients referred to the Bristol Eye Hospita l between 1984 and 1992. 9438 case notes of patients referred between 1987 and 1991 were examined in detail. Main outcome measures-Numbers o f referrals; rate of adult true positive glaucoma referrals. Results-R eferrals to the Bristol Eye Hospital were between 13.7% and 19.0% fewe r than expected after the introduction of the sight test fee. True pos itive glaucoma referrals were reduced by the same proportion. Conclusi ons-The numbers of patients being identified as requiring treatment or follow up for potentially blinding glaucoma have declined by nearly o ne fifth since the introduction of the sight test fee. An increased pr evalence of preventable blindness may result.