Positive predictive value of optometrist-initiated referrals for glaucoma

A study was conducted at the Moorfields Community Eye Clinic at Eating Hosp ital to determine the positive predictive value (ppv) of optometric referra ls for suspected glaucoma. The information reported in the referrals and th e reasons given for referral were also assessed and evaluated in relation t o the ppv. Information was gathered through prospective analysis of patient clinic notes. Ninety patients were referred over a six-month period of whi ch 87 fulfilled the inclusion criteria. The optometrist referral letters fo r 79 of these patients were supplied by the GP. Results indicate a ppv of 0 .43. The reason for referral in the majority of cases (48%) was raised IOP alone. However the most frequently reported mode of practice was a combinat ion of disc and IOP assessment (57%). In line with other research our study demonstrates that referral accuracy improves as the number of suspicious f indings increases. In addition those referrals reporting all three tests (I OP measurement, optic disc assessment and perimetry) are shown to have the highest ppv. Copyright (C) 1998 The College of Optometrists. Published by E lsevier Science Ltd. All rights reserved.