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News, Management

OBA's proposed changes unlikely to alter glaucoma detection rate: Glaucoma Australia

The changes to the 'Guidelines for Use of Scheduled Medicines' proposed by the Optometry Board of Australia will not alter the outcome for those who don't attend; will not alter the detection rate in those who attend but are not checked for glaucoma; and would be unlikely to alter the detection rate in those being checked currently but being missed, Glaucoma Australia said in its submission to the OBA on 4 February. 

"Glaucoma is known as a 'difficult-to-diagnose' disease, with up to 70% of neurons being lost before an individual notices vision loss themselves - hence the term 'the sneak thief of sight'" Glaucoma Australia said.

A high number of patients remain likely to be missed; an Australian study indicated up to 59% of subjects whose glaucoma was previously undiagnosed had visited an eye-care provider in the previous year. 
"The public needs to be seen by eye health professionals who can diagnose glaucoma by: undertaking a thorough history, followed by a comprehensive examination and only finally tests and investigations to confirm and document a diagnosis. "Once diagnosed, a treatment regime and management plan, based on an assessment of likely progression, risk of visual disability and many other medical and social factors is required, followed by rigorous follow-up to ensure treatment strategies are safe, tolerable and effective.

Glaucoma Australia contends it is the ophthalmologist who is able to recommend and initiate all types of glaucoma treatment, whereas the proposed OBA changes to the guidelines recommend optometrists be able to initiate eye drop therapy, only.

"This is somewhat limiting for the patient, who usually wants to know the risks and benefits of all therapeutic options (drops, laser or even incisional surgery), as they are unlikely to be covered meaningfully by an optometrist who can only prescribe one type of therapy," the Glaucoma Australia submission to the OBA said.


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