The Takeaway: fighting glaucoma with lessons from across the pond

For World Glaucoma Week, Lauren Entwistle on sustainable solutions to handle the growing number of glaucoma patients at health facilities in Australia…

When our reception clerks get out the sticky tape my heart sinks a little and I make sure to ask for an extra shot in my flat white before heading back to clinic. They’ve taken out the sticky tape because the glaucoma list is so big that it spills off one page and on to another, and they prefer to view it in a single glance as they furiously greet patients and mark them “attending”. I know it’s going to be a long and intense afternoon, not just for our staff but for our patients too.

We all know glaucoma as the Thief of Sight – that predator on peripheral vision that sneaks up on you before you know it. But maybe it’s time for new moniker. Personally, I like, “Clogger of Clinics”, because at my health service, our clinics are just that – clogged with a growing number of stable patients who perhaps don’t need the special attention of a consultant. As the waiting list for an appointment grows longer and longer, I worry that damage is occurring before we can get to it. It’s one of the biggest contributors to vision impairment and blindness in Australia, and with an aging population the problem is not going away.

I’m grateful that where I work, at the inner-city Royal Perth Hospital in Western Australia, we’re tired of seeing overbooked clinics and underserviced people. We are hungry for a sustainable solution to our problem. We’ve done our homework, examining models of care used in the UK and New Zealand, and are about to launch a pilot programme training ophthalmic nurses to perform all the necessary assessments involved in glaucoma management. The goal? Create a streamlined, nurse-led assessment service for stable POAG patients, using triage protocols and virtual review processes. I’m hopeful that this will be a model of care that can increase access to glaucoma management in the public sector. We’re not reinventing the wheel, but we sure are excited to climb on the bandwagon of utilising allied ophthalmic health professionals to their full potential. It’s for the sake of our patients, and the sake of our sanity, and I for one am glad to be along for the ride.

Image on top: Lauren practices on a slit lamp