Dah. Laidlaw et al., THE SIGHT TEST FEE - EFFECT ON OPHTHALMOLOGY REFERRALS AND RATE OF GLAUCOMA DETECTION, BMJ. British medical journal, 309(6955), 1994, pp. 634-636
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.