Introduction and overview

Introduction and overview

This quality standard covers care for people with chronic open angle glaucoma (COAG), suspected COAG or with ocular hypertension (OHT).


Chronic open angle glaucoma (COAG) is a common and potentially blinding condition. It is usually asymptomatic until advanced and many people will be unaware there is a problem with their eyes until severe visual damage has occurred. Ocular hypertension (OHT) is a major risk factor for developing COAG, although COAG can occur with or without raised eye pressure. Approximately 10% of UK blindness registrations are attributed to glaucoma and it accounts for over one million hospital eye service visits each year. Once diagnosed people with COAG need lifelong monitoring so that any progression of visual damage can be detected. Once lost, sight cannot be restored, and controlling the condition together with prevention, or at least minimisation of ongoing damage, is crucial to maintaining a sighted lifetime.

COAG, suspected COAG and OHT are common conditions which, if not diagnosed and managed correctly, can lead to partial sightedness (sight impairment) and blindness (severe sight impairment). This quality standard describes markers of high-quality, cost-effective care that, when delivered collectively, should contribute to improving the effectiveness, safety and experience of care for people with COAG, suspected COAG or with OHT in the following ways:

  • Enhancing quality of life for people with long-term conditions.

  • Ensuring that people have a positive experience of care.

  • Treating and caring for people in a safe environment and protecting them from avoidable harm.

The NHS Outcomes Framework 2011/12 is available.

Specifically, it is expected that achieving the high quality care set out in this quality standard will contribute to a reduction in Certificate of Visual Impairment registration rates for glaucoma (CVI: sight impaired and severely sight impaired).  


The quality standard for glaucoma requires that services should be commissioned from and coordinated across all relevant agencies encompassing the whole glaucoma care pathway, including primary, secondary and social care. An integrated approach to provision of services is fundamental to the delivery of high quality care to people with glaucoma. A local register of glaucoma-related conditions organised according to diagnosis (for example, chronic open angle glaucoma (COAG), suspected COAG, ocular hypertension (OHT), angle closure, secondary glaucoma) and sight impairment could be used to facilitate such integration.