14.02.2018

NICE Raises IOP Scores For Glaucoma Referrals

The UK's National Institute for Health and Care Excellence (NICE) raised the intraocular eye pressure (IOP) score that merits a glaucoma referral. Instead of the former 21mmHg rate, eye doctors will now need to show that their patient has an IOP score of 24mmHg or above for a referral.

This new regulation will cut down on unnecessary healthcare spending while still giving patients high-quality eye care. Health officials estimate that around 1.8 million UK residents have IOP scores between 22 and 23mmHg. Most of these patients aren't actually at a high risk of developing glaucoma and usually end up wasting NHS's valuable time and resources.

NICE says new research shows that 24mmHg is a more reasonable threshold for an elevated risk of chronic open angle glaucoma. Anyone with scores under 24mmHg should still see their eye care professional every year to check for eye diseases, but ophthalmologists shouldn't use these lower scores as a benchmark for referrals.

There are, of course, reasons besides high IOP pressure that doctors could use to refer a patient to a glaucoma expert. A few of these issues include optic nerve damage and visual field defects. If the ophthalmologist has reason to believe these readings indicate a higher incidence of glaucoma, they could refer the patient to a specialist.

NICE also recommends that all eye doctors use a Goldmann-type tonometer to check for IOP pressure. Any non-contact tonometry devices aren't considered accurate according NICE's standards.

Professor Paul Foster, a consultant ophthalmologist at Moorfields Eye Hospital, estimates that this 24mmHg regulation will cut unnecessary glaucoma referrals by almost 70 percent. Dr. Foster also says that this new recommendation will not adversely affect people's eye health.

To back up his claim, Dr. Foster pointed out an EPIC-Norfolk study that looked at over 8,600 eye patients and found that 76 percent of participants with undiagnosed eye diseases had normal IOP scores. This shows that elevated IOP scores aren't as reliable as other methods of eye screening. Dr. Foster said all eye doctors should learn from this study by taking a closer look at their patients' visual field tests and optic nerve scans.

Glaucoma is currently the second leading cause of blindness around the world. Although patients could experience symptoms like difficulty seeing in dim areas or blurred vision, these symptoms often don't occur until the disease has progressed a great deal in the person's eyes. That's why doctors recommend getting annual screenings to keep on top of glaucoma.

Although there's no treatment for glaucoma, there are many ways eye doctors can help patients manage their symptoms. A few of the most common treatment strategies include IOP reducing drops like Latanoprost and laser surgery.

To learn more about this new regulation and other important recommendations at NICE, anyone can visit NICE's blog, YouTube, Twitter, or Facebook pages. NICE also has a handy Guidance app available on both Android and Apple devices.

There are two main NICE offices in the UK: one at 10 Spring Gardens in London and the other in Piccadilly Plaza in Manchester.


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