Post COVID glaucoma service redesign utilising electronic patient triage and community optometry clinics (Fife, Scotland 2020—2022)

Authors: Nalagatla, Niharika ;

Parveen, Shameela;

Cheng, Kelvin K.W.;

Styles, Caroline;

Blaikie, Andrew;

Wilson, Peter;

Karri, Bhavani;

Chinn, David J.;

Sanders, Roshini;

Glaucoma Team;

Wong, Lisa;

Ramsay, Alan;

Halstead, Steven;

Boulton, Michelle;

Cummins, David;

Ferrier, Colin;

Galloway, Gavin;

Embrey, Elizabeth;

Preston, Duncan

Source: BMC Ophthalmology

Full text

: https://doi.org/10.1186/s12886-025-03882-7

Abstract

Background

COVID-19 caused a huge backlog of patients in glaucoma clinics. This study describes redesign of an entire glaucoma service with electronic patient triage to three levels and utilisation of the Scottish optometry infrastructure of upskilled optometrists.

Methods

2276 patients in glaucoma clinics were identified and triaged to three levels in keeping with Glauc-strat-fast guidance with local amendments. Every patient detail was entered into a bespoke glaucoma database to include demographics, clinical findings and social deprivation scores. The database generated automatic patient, GP and optometrist letters. Level one patients (482) were discharged within the Scottish general optometry service contract. Level two patients (714) were discharged to glaucoma accredited community optometry clinics. The glaucoma consultants would discuss the optometry decision making through screen share once a week. Level three patients (1080) were retained in hospital. All outcomes were audited and analysed 24 months after the new service.

Results

Statistically significant parameters were found between the three groups, to include more normal eyes, less mean deviation on visual fields and less social deprivation in level one patients. After 24 months level one patients had a return rate of 40.2%, mainly for other diseases with only 20.4% retained within hospital or level two. 9.4% of level two patients returned to hospital with retention of only 2.7% in hospital at 24 months.

Conclusion

Glaucoma patients in Scotland can be appropriately triaged to glaucoma accredited community optometry clinics. This frees capacity within hospital to see patients with moderate and severe disease in a timely fashion, for best visual outcomes.

Rights

Copyright © The Author(s) 2025. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modifed the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Cite as

Nalagatla, N., Parveen, S., Cheng, K., Styles, C., Blaikie, A., Wilson, P., Karri, B., Chinn, D., Sanders, R., Team, G., Wong, L., Ramsay, A., Halstead, S., Boulton, M., Cummins, D., Ferrier, C., Galloway, G., Embrey, E. & Preston, D. 2025, 'Post COVID glaucoma service redesign utilising electronic patient triage and community optometry clinics (Fife, Scotland 2020—2022)', BMC Ophthalmology, 25, article no: 50. https://doi.org/10.1186/s12886-025-03882-7

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Identifiers

DOI: https://doi.org/10.1186/s12886-025-03882-7

Repository URI: https://hdl.handle.net/10023/31819