Glaucoma

Acute glaucoma

Red, hard, aching eye, hazy cornea and blurred vision

• Where to refer:
  • Eye Casualty

 

Primary open angle glaucoma

• Information to include
  • Optometry referral must indicate disc and/or field defect compatible with glaucoma, or angle at risk of closure. Patients with family history are screened by optometrist
• How to refer
  • Routine with copy of optometrist referral with info on refraction, IOP, disc and field enclosed if abnormal.
  • Book fields
  • If re-referral, refer to current consultant
  • If transfer from another hospital eye service unit include last hospital eye service letter

 

Raised intraocular pressure (IOP)

Emergency referral criteria:

• If a patient’s IOP is measured by a community optometrist at 35 mmHg or over with symptoms of primary angle closure the patient should be referred to the Emergency Eye Clinic

 

Urgent referral criteria:

• Asymptomatic patients with an IOP of 35 mmHg or over measured by a community optometrist

• Patients with an IOP of 30mmHg or over following a repeat IOP reading via slit lamp GAT (Goldmann applanation tonometry) and full threshold/suprathreshold perimetry

 

Other referral criteria:

• Patients with an IOP of 24 – 29 mmHg  or over following a repeat IOP reading via slit lamp GAT (Goldmann applanation tonometry) and full threshold/suprathreshold perimetry

All patients with one or more of the following detected during GOS or private sight test should be referred to the hospital eye services:

 • Suspect visual field

• Suspicious optic nerve head

• Suspicious anterior chamber angle found during GOS or private sight test

 

References

Raised intraocular pressure (National Evidence Based Intervention). Cornwall and IoS Commissioning Policy and Evidence Based Interventions, April 2025.

Page Review Information

Partial Review 20/05/2025

Next review due 20/05/2026

Contributors: RMS GP Sifter: Dr Laura Lomas

Mr William Westlake