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Glaucoma: diagnosis and management of chronic open angle glaucoma and ocular hypertension [CG85]

Measuring the use of this guidance

Recommendation: 1.1.1

At diagnosis offer all people who have COAG, who are suspected of having COAG or who have OHT all of the following tests: • IOP measurement using Goldmann applanation tonometry (slit lamp mounted) • central corneal thickness (CCT) measurement • peripheral anterior chamber configuration and depth assessments using gonioscopy • visual field measurement using standard automated perimetry (central thresholding test) • optic nerve assessment, with dilatation, using stereoscopic slit lamp biomicroscopy with fundus examination.

What was measured: Goldmann tonometry assessment assessed at diagnosis in shared care model
Data collection end: February 2010
100%
Number that met the criteria: 50 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Goldmann tonometry assessment assessed at diagnosis in traditional DGH model
Data collection end: June 2010
100%
Number that met the criteria: 50 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Central corneal thickness assessment assessed at diagnosis in shared care model
Data collection end: February 2010
96%
Number that met the criteria: 48 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Central corneal thickness assessment assessed at diagnosis in traditional DGH model
Data collection end: June 2010
58%
Number that met the criteria: 29 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Gonioscopy assessment assessed at diagnosis in shared care model
Data collection end: February 2010
96%
Number that met the criteria: 48 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Gonioscopy assessment assessed at diagnosis in traditional DGH model
Data collection end: June 2010
74%
Number that met the criteria: 37 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Optic disc assessment assessed at diagnosis in shared care model
Data collection end: February 2010
100%
Number that met the criteria: 50 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Optic disc assessment assessed at diagnosis in traditional DGH model
Data collection end: June 2010
100%
Number that met the criteria: 50 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Visual field assessment at diagnosis in shared care model
Data collection end: February 2010
100%
Number that met the criteria: 50 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Visual field assessment at diagnosis in traditional DGH model
Data collection end: June 2010
100%
Number that met the criteria: 50 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417


Recommendation: 1.1.4

Obtain an optic nerve head image at diagnosis for baseline documentation

What was measured: Baseline optic nerve image in shared care model
Data collection end: February 2010
74%
Number that met the criteria: 37 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Baseline optic nerve image in traditional DGH model
Data collection end: June 2010
10%
Number that met the criteria: 5 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417


Recommendation: 1.2.1

Offer Goldmann applanation tonometry (slit lamp mounted) to all people with COAG, who are suspected of having COAG or who have OHT at each monitoring assessment

What was measured: Proportion of patients at each monitoring visit where a Goldmann tonometry was carried out in shared care model
Data collection end: February 2010
100%
Number that met the criteria: 50 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Proportion of patients at each monitoring visit where a Goldmann tonometry was carried out in a traditional DGH model
Data collection end: June 2010
100%
Number that met the criteria: 50 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417


Recommendation: 1.2.3

Offer Van Herick's peripheral anterior chamber depth assessment to all people with COAG, who are suspected of having COAG or who have OHT at each monitoring assessment

What was measured: Anterior chamber depth assessment carried out at each monitoring visit in shared care model
Data collection end: February 2010
94%
Number that met the criteria: 47 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Anterior chamber depth assessment carried out at each monitoring visit in traditional DGH model
Data collection end: June 2010
8%
Number that met the criteria: 4 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417


Recommendation: 1.2.7

Offer stereoscopic slit lamp biomicroscopic examination of the optic nerve head to all people with COAG, who are suspected of having COAG or who have OHT at monitoring assessments (see tables 4 and 5 for recommended monitoring intervals).

What was measured: Patients treated according to NICE recommendations in shared care model
Data collection end: June 2011
100%
Number that met the criteria: 50 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Patients treated according to NICE recommendations in traditional DGH model
Data collection end: June 2011
90%
Number that met the criteria: 45 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417


Recommendation: 1.2.10

Monitor at regular intervals people with OHT or suspected COAG recommended to receive medication (see recommendation 1.3.1), according to their risk of conversion to COAG (see table 4).

What was measured: Patients whose planned review was in accordance with NICE recommendations in shared care model
Data collection end: February 2010
92%
Number that met the criteria: 46 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Patients whose planned review was in accordance with NICE recommendations in traditional DGH model
Data collection end: June 2010
86%
Number that met the criteria: 43 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Patients whose actual review was in accordance with NICE recommendations in traditional DGH model
Data collection end: June 2010
66%
Number that met the criteria: 33 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Patients whose actual review was in accordance with NICE recommendations in shared care model
Data collection end: February 2010
92%
Number that met the criteria: 46 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417


Recommendation: 1.3.1

Offer people with OHT or suspected COAG with high IOP treatment based on estimated risk of conversion to COAG using IOP, CCT and age (see table 6).

What was measured: Patients treated according to NICE recommendations in shared care model
Data collection end: February 2010
96%
Number that met the criteria: 48 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417

What was measured: Patients treated according to NICE recommendations in traditional DGH model
Data collection end: June 2010
100%
Number that met the criteria: 50 / 50
Area covered: Regional
Source: Chawla, A., Patel, I., Yuen, C., & Fenerty, C. (2012). Patterns of adherence to NICE Glaucoma Guidance in two different service delivery models. Eye, Vol 26, pp 1412-1417



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