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© 1997 Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom

research-article

The Bristol shared care glaucoma study – validity of measurements and patient satisfaction


Selena F. Gray, Consultant Senior Lecturer in Public Health Medicine1
Ian C. Spencer, Research Registrar2
Paul G. Spry, Research Optometrist2
Sara T. Brookes, Research Assistant Medical Statistics1
Ian A. Baker, Consultant in Public Health Medicine3
Tim J. Peters, Senior Lecturer in Medical Statistics1
John M. Sparrow, Consultant Senior Lecturer in Ophthalmology2
David L. Easty, Professor of Ophthalmology2

1Department of Social Medicine, University of Bristol, Canynge Hall Whiteladies Road, Bristol BS8 2PR
2Department of Ophthalmology, University of Bristol, Bristol Eye Hospital, Lower Maudlin Street Bristol BS1 2LX
3Department of Public Health Medicine, Avon Health, 10 Dighton Street Bristol BS2 8EE


Address correspondence to Dr Selena Gray

BACKGROUND: The aims of the study were to determine (1) whether community optometrists are able to make valid measurements of visual parameters in patients with established or suspect primary open angle glaucoma and (2) patient satisfaction with follow-up by community optometrists.

METHODS: A randomized study was carried out in the former county of Avon in South West England with patients allocated to follow-up by the hospital eye service or by community optometrists. The subjects were 403 patients with established or suspected primary open angle glaucoma attending Bristol Eye Hospital and meeting defined inclusion and exclusion criteria. The main outcome measures were (1) measurements of key visual parameters (intraocular pressure, visual fields and cup/disc ratio) made by hospital eye service and community optometrists, compared with a research clinic reference standard at baseline, and (2) patient satisfaction at baseline and at six months.

RESULTS: Community optometrists were able to make measurements of comparable accuracy to those made in the hospital eye service. Patients were significantly more satisfied with a number of aspects of care provided by community optometrists, particularly those relating to waiting times, compared with those from the hospital eye service.

CONCLUSIONS: Community optometrists are able to make measurements of key visual parameters in patients with established or suspect primary open angle glaucoma which are of comparable quality to the hospital eye service. Follow-up by community optometrists is acceptable to patients. The costs of each option are reported elsewhere.

Keywords: glaucoma, shared care, patient satisfaction, optometrists


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