Northern Ireland Enhanced Service: Ocular Hypertension Review and Monitoring (Glaucoma Care Pathway)

We are delighted to offer this service in the practice, Dearbháil has worked in Hospital Glaucoma clinics since 2010 and continues to work part-time in the Glaucoma Clinic in the Belfast Trust. She will see each patient for their review.

Those who are eligible for review have previously been seen and diagnosed with Ocular Hypertension (OHT) in the Glaucoma service. This allows patients to be reviewed promptly and usually closer to home than attending the Hospital Clinics.

We will contact you when you are due for review and arrange an appointment with Dearbháil at a suitable time.

What to Expect at Your Appointment

• In the clinic room, Dearbháil will check your Visual Acuity (how many letters you can read on the letter chart) with your distance spectacles on (please take these to your appointment.)
• She will then check your intraocular pressure (IOP) [sometimes referred to as "Eye Pressure"]
• Your Pupils will be dilated (you will not be able to drive for 2-3 hours after your appointment- please make the necessary arrangements for this.)
• We will then ask you to do a Visual Field test- to check your peripheral vision.
• Dearbháil will then examine you at the slit lamp using a specific lens to examine your Optic Nerves in particular.
• Prior to your appointment we will have received communication from the Hospital Glaucoma clinic detailing your “Clinical Management Plan.” This plan provides information about your eye condition, any previous treatment and your target IOP (Intraocular pressure). Dearbháil will explain all her findings with you at the end of the appointment and discuss appropriate review.

Please leave between 30-60 minutes for your appointment.

What is Ocular Hypertension?

Ocular hypertension (OHT) is generally defined as consistently elevated intraocular pressure (IOP) in one or both eyes in the absence of optic nerve damage, visual field defect or other pathology that could explain high IOP.

• Estimated to affect between 4.5% to 9.4% for those aged > 40 years, with prevalence increasing with age.
• Higher IOP can increase the risk of developing Glaucoma. 10% of people with untreated OHT develop primary open angle glaucoma (POAG) in 5 years
• There are generally no symptoms of Ocular Hypertension (OHT)
• It is important to monitor those with OHT to try to identify those at greatest risk of developing glaucoma and offer treatment if required.

What is the Treatment for Ocular Hypertension?

Not all people with OHT need treatment but for those that do the treatment options include:

• Topical Treatment with drops
• Laser procedure to lower IOP- Selective Laser Trabeculoplasty (SLT)
• Surgery- In rare cases where the IOP is uncontrolled with either drops or laser treatment an Ophthalmologist may consider surgery to lower IOP in one or both eyes.

Websites for further information:

• https://www.youtube.com/watch?v=Y3BGWstK2Wk
• https://glaucoma.uk/ocular-hypertension/
• https://pubmed.ncbi.nlm.nih.gov/12049574/
• https://www.thelancet.com/article/S0140-6736(18)32213-X/fulltext
• https://glaucoma.uk/about-glaucoma/
• https://www.rnib.org.uk/eye-health/eye-conditions/glaucoma