Abstract
Purpose :
To present the outcomes of virtual glaucoma clinics (VGCs) at Moorfields Eye Hospital, south Division, London. Patient eligibility was expanded beyond the diagnosis of ocular hypertension and early glaucoma, including most types of glaucoma and in various stages of disease progression.
Methods :
Patients with at least 3 follow-up visits post initial virtual review were included. All patients had visual acuity (VA) and field testing, intraocular pressure (IOP) measurement, optical coherence tomography of the retinal nerve fiber layer scan and an optic nerve photo taken. Assessment of findings was performed by consultants only. Outcomes of these consultations and location of future consultations were recorded.
Results :
A total number of 2015 patients were included. The majority was diagnosed with primary open angle glaucoma (70%). Most eyes had comorbidities (64%), amongst which macular degeneration was the most prevalent (9%). Seventy three percent of them had undergone previous surgery (42% phacoemulsification and 1% glaucoma surgery). At first visit, mean VA of better eye was 85.4 letters, average IOP of all eyes was 16.3mmHg and average mean deviation (MD) of all eyes was -5.01 (-6.85 for those with surgery, -4.56 for those without surgery). After the first visit 57% of patients were rebooked in the VGC, 13% were discharged, 30% went back to face-to-face clincis and the average review timeframe was 269 days. After the third visit, 43% of patients remained under VGC. There were no statistically significant changes in VA, IOP and MD during follow up. There were no serious incidents or lost to follow-up patients.
Conclusions :
VGCs can be expanded safely and efficiently and include a significant glaucoma patient population, within the resources of existing hospital eye service. This would enable glaucoma services to cope with increasing demand, prevent lost-to-follow up patients, efficiently redistribute existing resources to patients who need interventions and improve patient experience.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.