Glaucoma referral and safe discharge

Glaucoma is the leading cause of irreversible blindness worldwide and is the second most common cause of visual impairment in the UK.

Remit and target users

This guideline provides evidence based recommendations and best-practice guidance on the primary-care assessment and referral of patients with suspected glaucoma, of any subtype, from the community into secondary eye-care services and the safe discharge of patients from secondary eye-care services back into the community. The guideline also makes recommendations identifying which patients can be safely followed up in the community.

This guideline will be of particular interest to community optometrists, general practitioners and hospital-based healthcare professionals involved in glaucoma care including ophthalmologists, optometrists, specialist nurses and orthoptists. It will also be of interest to patients and carers.

How this guideline was developed

This guideline was developed using a standard methodology based on a systematic review of the evidence. Further details can be found in SIGN 50: A Guideline Developer’s Handbook.

Keeping up to date

This guideline was first issued in 2015 and revalidated in April 2018. Details can be found in the scoping report. It will be considered for review in three years. The review history, and any updates to the guideline in the interim period, will be noted in the review report.

If you are aware of any new evidence that would update this guideline please complete a change request form  and return to: roberta.james@nhs.scot

Impact and implementation

A pilot project to understand the impact and implementation of SIGN 144 was undertaken between August 2017–2018. The results showed that in the locations that undertook audit there were improvements in first visit discharge rates and completeness of referrals. Community optometrists that participated in the 2016 NES training or 2017 NES optometry conference workshop reported increased confidence in decision making and patient management.

​Current 3-7 years

Some recommendations may be out of  date, declaration of interests governance may not be in line with current policy.