title: The sight test fee: effect on ophthalmology referrals and rate of glaucoma detection.
abstract: OBJECTIVE
  To assess changes, if any, in the numbers of referrals and outcome of glaucoma referrals to the hospital eye service since the introduction of the sight test fee on 1 April 1989.
  
  
  METHODS
  Review of referral records and clinical notes.
  
  
  METHODS
  Referrals to the Bristol Eye Hospital.
  
  
  METHODS
  51,919 patients referred to the Bristol Eye Hospital between 1984 and 1992. 9438 case notes of patients referred between 1987 and 1991 were examined in detail.
  
  
  METHODS
  Numbers of referrals; rate of adult true positive glaucoma referrals.
  
  
  RESULTS
  Referrals to the Bristol Eye Hospital were between 13.7% and 19.0% fewer than expected after the introduction of the sight test fee. True positive glaucoma referrals were reduced by the same proportion.
  
  
  CONCLUSIONS
  The numbers of patients being identified as requiring treatment or follow up for potentially blinding glaucoma have declined by nearly one fifth since the introduction of the sight test fee. An increased prevalence of preventable blindness may result.
authors.affiliation: Bristol Eye Hospital.
authors.forename: D A
authors.initials: DA
authors.lastname: Laidlaw
authors.forename: P A
authors.initials: PA
authors.lastname: Bloom
authors.forename: A O
authors.initials: AO
authors.lastname: Hughes
authors.forename: J M
authors.initials: JM
authors.lastname: Sparrow
authors.forename: V J
authors.initials: VJ
authors.lastname: Marmion
mesh_terms: D000328:Adult; D005901:Glaucoma / Q000175:diagnosis* / Q000191:economics / Q000517:prevention & control; D017722:Hospital Charges; D006782:Hospitals, Special / Q000191:economics*; D006801:Humans; D009885:Ophthalmology / Q000191:economics; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013222:State Medicine / Q000191:economics; D006113:United Kingdom; D015351:Vision Screening / Q000191:economics; D014787:Vision Tests / Q000191:economics* / Q000706:statistics & numerical data