Meeting presentation: Data presented at the UK and Eire Glaucoma Society Meeting, Liverpool, December 2009.
Attitudes of consultant ophthalmologists in the UK to initial management of glaucoma patients presenting with severe visual field loss: a national survey
Article first published online: 14 JUN 2011
© 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists
Clinical & Experimental Ophthalmology
Volume 39, Issue 9, pages 858–864, December 2011
How to Cite
Stead, R., Azuara-Blanco, A. and King, A. J. (2011), Attitudes of consultant ophthalmologists in the UK to initial management of glaucoma patients presenting with severe visual field loss: a national survey. Clinical & Experimental Ophthalmology, 39: 858–864. doi: 10.1111/j.1442-9071.2011.02574.x
- Issue published online: 1 DEC 2011
- Article first published online: 14 JUN 2011
- Accepted manuscript online: 18 APR 2011 08:10AM EST
- Received 13 December 2010; accepted 24 March 2011.
- advanced glaucoma;
- intraocular pressure;
Background: Recent National Institute of Clinical Excellence guidance suggests primary surgery should be offered to patients presenting with glaucoma with severe visual field loss. We undertook a survey of UK consultant ophthalmologists to determine if this represents current practice and explore attitudes towards managing patients with advanced glaucoma at presentation.
Design: Questionnaire evaluation study.
Participants: All consultant ophthalmologists currently practicing in the UK.
Methods: A single-page questionnaire was posted to all consultants (n = 910) currently practicing in the UK along with a pre-paid return envelope. A second questionnaire was sent to non-responders (n = 459).
Main Outcome Measures: Questionnaire responses.
Results: 626 responses were received representing 68.8% of the population surveyed. 152 (24%) volunteered a specialist interest in glaucoma. Consensus opinion for both glaucoma specialists (64.9%) and non-glaucoma specialists (62.4%) was to start with primary medical therapy, most commonly citing surgical risk as the primary reason (23% and 22%, respectively) for this approach. Most felt the highest intraocular pressure measurement during follow up (measured in clinic) was the most important variable for prevention of further visual loss (60% of glaucoma specialists and 55% of non-glaucoma specialists). Eighty-three per cent of all responders suggested they would change their practice if evidence supporting primary surgery as a safe and more effective approach existed.
Conclusions: Recent National Institute of Clinical Excellence guidance does not reflect the current management approach of UK ophthalmologists. The primary concern was related to potential complications of surgery although most practitioners would be willing to change their practice if evidence existed supporting primary surgery in patients presenting with advanced glaucoma.