THE CHANGING PATTERN OF GLAUCOMA REFERRALS BY OPTOMETRISTS

Purpose To identify any change in optometric referral patterns for sus pect glaucoma over a 5 year period. Method A restrospective analysis w as carried out of referrals for suspect glaucoma to a hospital glaucom a clinic from 1988 and 1993. Results There was a significant decrease in the positive referral rate with time from 56% in 1988 to 37% in 199 3 (p = 0.02). Intraocular pressures (IOPs) of all patients prior to re ferral and at presentation to the glaucoma clinic were significantly h igher in 1988 (25.1 and 25.6 mmHg respectively) than in 1993 (22.4 and 23.0 mmHg respectively, p < 0.0005). However, the presenting IOPs of eyes with glaucoma were similar in the cohorts (27.5 vs 26.4 mmHg, p = 0.33). Prior to referral, optometrists performed visual fields on 28% of patients in 1988 and on 48% in 1993 (p 0.01), giving an estimate o f the cup/disc ratio in 15% of patients in 1988 and 41% in 1993 (p = 0 .0004). Conclusions The increased false positive referral rate appears to be associated with the increasing use of visual field analysers by optometrists and a willingness to refer at lower IOPs. increased fals e positive referrals result in increased waiting times for hospital as sessment.