Glaucoma-service provision in Scotland: introduction and need for Scottish Intercollegiate Guidelines Network guidelines.
OBJECTIVE
To describe the pattern of glaucoma-service delivery in Scotland and identify areas for improvement, taking into account Scottish General Ophthalmic Services (GOS) arrangements and the Eye Care Integration project, and to design Scottish Intercollegiate Guidelines Network (SIGN) guidelines to refine the primary and secondary interface of glaucoma care.


METHODS
A glaucoma-survey questionnaire was sent to all consultant glaucomatologists in Scotland. The design of SIGN guidelines was based on the results of the questionnaire using SIGN methodology.


RESULTS
Over 90% of Scottish glaucoma care is triaged and delivered within hospital services. Despite GOS referral, information is variable. There are no consistent discharge practices to the community. These results led to defined research questions that were answered, thus formulating the content of the SIGN guidelines. The guideline covers the assessment of patients in primary care, referral criteria to hospital, discharge criteria from hospital to community, and monitoring of patients at risk of glaucoma.


CONCLUSIONS
With increasing age and limitations to hospital resources, refining glaucoma pathways between primary and secondary care has become a necessity. Scotland has unique eye care arrangements with both the GOS and Eye Care Integration project. It is hoped that implementation of SIGN guidelines will identify glaucoma at the earliest opportunity and reduce the rate of false-positive referrals to hospital.
SIGN Working Group, SIGN Guidelines for Glaucoma Referral and Safe Discharge, Edinburgh, Scotland.
Andreas
A
Syrogiannis
Healthcare Improvement Scotland, Edinburgh, Scotland.
Alan P
AP
Rotchford
SIGN Working Group, SIGN Guidelines for Glaucoma Referral and Safe Discharge, Edinburgh, Scotland.
Pankaj Kumar
PK
Agarwal
SIGN Working Group, SIGN Guidelines for Glaucoma Referral and Safe Discharge, Edinburgh, Scotland.
Manjula
M
Kumarasamy
SIGN Working Group, SIGN Guidelines for Glaucoma Referral and Safe Discharge, Edinburgh, Scotland.
Donald
D
Montgomery
SIGN Working Group, SIGN Guidelines for Glaucoma Referral and Safe Discharge, Edinburgh, Scotland.
Jennifer
J
Burr
SIGN Working Group, SIGN Guidelines for Glaucoma Referral and Safe Discharge, Edinburgh, Scotland ; Healthcare Improvement Scotland, Edinburgh, Scotland.
Roshini
R
Sanders
SIGN guidelines; community care; glaucoma; referral