| Initial management of ocular hypertension and primary open-angle glaucoma: an evaluation of the royal college of ophthalmologists' guidelines. | |
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MedLine Citation:
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PMID: 12928677 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: The purpose of this study was to identify any consensus of opinion among consultant ophthalmologists in Wales with respect to the initial management of glaucoma referrals based on the published guidelines of the Royal College of Ophthalmologists (RCO) and to compare consultant opinion with the practice in a typical hospital. METHOD: The RCO guidelines document was studied to identify clear statements, which could be adopted as standards for audit purposes. A questionnaire was designed and sent to all consultant ophthalmologists in Wales (n=37) to obtain their opinions. An audit was performed of 100 consecutive patients referred to our unit as glaucoma suspects with regard to initial management. Descriptive statistical analysis was performed. RESULTS: A good response rate for a postal questionnaire was obtained (81%) with 79.1% of responders finding the guidelines of at least some help. Levels of agreement with the definitions of ocular hypertension (OH) and primary open-angle glaucoma (POAG) were 76.7 and 86.7%, respectively. There was consensus of consultant opinion regarding many of the elements of the baseline clinical assessment with the significant exceptions of the necessity for dilated fundoscopy, gonioscopy, retinal nerve fibre layer assessment, and drawing of optic discs. The various 'clinical scenarios' for management of the RCO document were not all endorsed. The clinical audit results of the initial management of glaucoma referrals accurately reflected the consensus of the consultant opinion. DISCUSSION: The RCO guidelines document represents a useful contribution to the management of patients with OH and POAG. Nevertheless, considerable variation in opinion exists concerning even the most basic areas. With the advent of clinical governance, bridging the gap between the conclusions of College working parties and realities of everyday practice will assume greater importance. |
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Authors:
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Y F Choong; N Devarajan; A Pickering; S Pickering; M W Austin |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Eye (London, England) Volume: 17 ISSN: 0950-222X ISO Abbreviation: Eye (Lond) Publication Date: 2003 Aug |
Date Detail:
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Created Date: 2003-08-20 Completed Date: 2003-10-30 Revised Date: 2009-11-03 |
Medline Journal Info:
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Nlm Unique ID: 8703986 Medline TA: Eye (Lond) Country: England |
Other Details:
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Languages: eng Pagination: 685-90 Citation Subset: IM |
Affiliation:
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Department of Ophthalmology Singleton Hospital Sketty Swansea, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Attitude of Health Personnel Consultants Glaucoma, Open-Angle / diagnosis, therapy* Guideline Adherence / statistics & numerical data Humans Medical Audit / methods Ocular Hypertension / diagnosis, therapy* Practice Guidelines as Topic* Professional Practice / statistics & numerical data Questionnaires Wales |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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