Specialist commentator comments
Comments on this technology were invited from clinical specialists working in the field and relevant patient organisations. The comments received are individual opinions and do not represent NICE's view.
All 5 specialist commentators were familiar with or had used ORA G3 before.
One specialist commentator confirmed that ORA G3 is the only device that can measure corneal hysteresis, but noted that how well corneal hysteresis predicts glaucoma is unproven.
One specialist commentator remarked that if a well-conducted, prospective study did show that corneal hysteresis was a reliable risk factor for glaucoma it could lead to better patient outcomes, specifically: better detection of the disease, earlier treatment, and fewer assessments for people at low risk of development or progression.
Another stated that ORA G3 may improve clinical outcomes by identifying people at high risk of development or progression through measuring corneal hysteresis. People determined to be at low risk would need fewer hospital visits and less treatment.
The specialist commentators stated that if corneal hysteresis were proven to be a reliable risk factor for glaucoma, it would allow for more accurate targeted follow-up. This would mean less unnecessary treatment for people at lower risk.
One specialist commentator said that because ORA G3 is an extra test, it will increase costs. However, they acknowledged that it has the potential to be cost saving over time.
Another specialist commentator noted that ORA G3 could reduce the number of senior or specialist staff needed in a clinic. Because the device is relatively easy to use and does not need eye drops or contact with the eye, it can be used by more junior staff.
Another commentator suggested that ORA G3 could be used instead of current intraocular pressure measurement in primary and secondary care.
One specialist commentator felt that corneal hysteresis is not a proven risk factor for glaucoma. Another considered corneal hysteresis to be a risk factor but, thought that corneal compensated intraocular pressure was most useful clinically. A third specialist commentator did not think that corneal hysteresis was a risk factor but observed that it may be a helpful indicator for patients who cannot have some of the tests recommended by NICE. Another explained that they use corneal hysteresis as a marker for measurement error by Goldmann applanation tonometry, rather than a risk factor in itself.
Two specialist commentators felt that as an extra device, finding space for ORA G3 in a clinic may be an issue. However, most of the commentators did not foresee any problems with space for the device.