Glaucoma diagnosis

  • Eye health sector launches new SAFE approach to assist in improving the systems around the delivery of eye health and sight loss services in England

    PRESS RELEASE
    10 April 2018

    The Clinical Council for Eye Health Commissioning (CCEHC), which represents the leading clinical professions and sight loss charity organisations in the eye-care sector, has launched a new Systems and Assurance Framework for Eye-health (SAFE)1.

    Increasing demands on eye health services due to the ageing population and the availability of new treatments continue to create capacity issues within the hospital eye service as well as pressures on general practice and social care. SAFE provides a sustainable, consistent and coordinated approach to delivering efficient eye health and sight loss pathways.

    SAFE is aimed at those involved in eye health and sight loss services: Clinical Commissioning Groups (CCGs) and local authority commissioners, Local Eye Health Networks and providers across health and social care.

    SAFE is a series of core constructs and technical tools based on four principles:

    1. System-based approach to the planning, commissioning and provision of services, to improve patient flows and patient experience, which is operable at the level of an Integrated Care System (ICS) or Sustainability and Transformation Partnerships (STP) level.
    2. Assurance in delivering better outcomes for patients, and reduce duplication and waste of resources for the NHS
    3. Framework that provides consistency in the approaches taken to improve access, availability and integration of services taking into account the full range and complexity of care pathways that increasingly involve multiple providers and settings to deliver services across health and social care
    4. Eye-health conditions covered are the main adult chronic (Glaucoma and Age-related Macular Degeneration) and high-volume conditions (Cataract), but can be applied to any eye condition.

    Launching the new framework Parul Desai, Chair of the Clinical Council said:

    “The development of SAFE has been clinically led and clinically driven to ensure safe and effective services are available to meet individual and population eye health needs. This cross-sector initiative provides the basis for the organisation and delivery of pathways of care that patients can reasonably expect wherever they may live, with processes that provide assurance on quality and governance.”

    References:
    1. SAFE – System and Assurance Framework for Eye-health. 2018. Clinical Council for Eye Health Commissioning. www.ccehc.org.uk

    ENDS

    For media enquiries please contact: Ann-Marie Stevens, PR Manager, telephone: 020 7766 4342, email: annmarie.stevens@college-optometrists.org

    Notes to editors

    The Clinical Council for Eye Health Commissioning (CCEHC) represents the leading clinical professions and charity organisations in the eye-care sector. It is an independent advisory body providing evidence-based national clinical leadership, advice and guidance to policy makers in health, social care and public health, and those commissioning and providing eye health services in England. It is recognised as such through a Memorandum of Understanding with NHS England.
    Its member organisations are:
    • The Royal College of Ophthalmologists
    • The College of Optometrists
    • Association of Directors of Adult Social Services
    • Association of British Dispensing Opticians
    • British and Irish Orthoptic Society
    • Faculty of Public Health
    • Optical Confederation (including the Local Optical Committee Support Unit)
    • Royal College of General Practitioners
    • Royal College of Nursing (Ophthalmic nursing forum)
    • Royal National Institute of Blind People
    • International Glaucoma Association
    • Macular Society
    • Vision UK

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  • The IGA welcomes new NICE glaucoma guideline

    The IGA welcomes the publication of the revised NICE glaucoma guideline. This provides clear referral criteria so that people are monitored in the setting which is most appropriate to them. Many can be managed by community optometrists with the relevant training, which is often more convenient. This lessens the number of people with a low risk of developing glaucoma, being sent to hospitals, which are often over-stretched and struggling to cope with the demand on their services”.

    https://www.nice.org.uk/news/article/people-at-a-low-risk-of-developing-glaucoma-can-avoid-unnecessary-referral-says-nice

     

     

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  • IGA trustee Professor Anthony King comments on new test to detect glaucoma

    "This is a potentially significant new test. It is novel in its application. There is no real comparable test available that looks at the eye in such a detailed way and it would certainly add to our current ability to evaluate patients with glaucoma. The researchers have shown that it appears to be safe and it can identify patients who have glaucoma and it is possibly predictive of patients who will have glaucoma progression so all of that is very positive for the future.

    "It is a very experimental paper and the way that the test is administered wouldn't be at all practical in the NHS. It's time consuming and involves an intravenous injection. Patients need to have pupils dilated and then there is a need to have scans so they would have to remain in the department for several hours, so it would be both time consuming for the patient and time consuming for the ophthalmology service. However it's likely that with future research these things could be refined significantly to hone it down to a more efficient delivery.

    There is no cure, but we can manage glaucoma to stop it progressing so this is a test that allows us to diagnose glaucoma at an earlier stage and also identify patients more likely to progress more quickly to implement treatments to stop it from progressing. Often one of the difficulties with glaucoma is that there are no early signs and people can have significant visual field loss before they are detected. As with most conditions the later that a condition is identified, the more difficult it becomes to treat it effectively. So many people will have glaucoma without being aware of it and they only become aware of it when they go to their optician for a routine evaluation and it is picked up then."

    The IGA believes that everyone should have an eye health check every two years and more regularly if recommended by a health professional.

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    New eye test detects earliest signs of glaucoma

    A SIMPLE eye test could help solve the biggest global cause of irreversible blindness, glaucoma.

    In clinical trials, the pioneering diagnostic - developed by researchers at University College London (UCL) and the Western Eye Hospital - allowed doctors to see individual nerve cell death in the back of the eye.

    Glaucoma affects 60 million people in the world, with 1 in 10 suffering total sight loss in both eyes.

    Early detection means doctors can start treatments before sight loss begins. The test also has potential for early diagnosis of other degenerative neurological conditions, including Parkinson’s, Alzheimer’s and multiple sclerosis.

    Results of first clinical trials with glaucoma patients are published today (28/04/17) in the journal BRAIN.

    Professor Francesca Cordeiro at UCL Institute of Ophthalmology, who led the research, said: “Detecting glaucoma early is vital as symptoms are not always obvious. Although detection has been improving, most patients have lost a third of vision by the time they are diagnosed. Now, for the first time, we have been able to show individual cell death and detect the earliest signs of glaucoma. While we cannot cure the disease, our test means treatment can start before symptoms begin. In the future, the test could also be used to diagnose other neurodegenerative diseases.”

    Loss of sight in patients with glaucoma is caused by the death of cells in the retina at the back of the eye. This cell death is called apoptosis.

    As with other neurodegenerative conditions, more and more nerve cells are lost as the disease progresses.

    Professor Philip Bloom, Chief Investigator at Western Eye Hospital, part of Imperial College Healthcare NHS Trust, added: “Treatment is much more successful when it is begun in early stages of the disease, when sight loss is minimal. Our developments mean we could diagnose patients 10 years earlier than was previously possible.”

    The technique developed is called DARC, which stands for detection of apoptosing retinal cells. It uses a specially developed fluorescent marker which attaches to cell proteins when injected into patients. Sick cells appear as white fluorescent spots during eye examination. UCL Business, the commercialisation company of UCL, holds the patents for the technology.

    The examination uses equipment used during routine hospital eye examinations. Researchers hope that eventually it may be possible for opticians to do the tests, enabling even earlier detection of the disease.

    The research is funded by Wellcome Trust.

    Bethan Hughes, from Wellcome’s Innovation team said: “This innovation has the potential to transform lives for those who suffer loss of sight through glaucoma, and offers hope of a breakthrough in early diagnosis of other neurodegenerative diseases. Loss of sight as you age is an incredibly difficult disability, impacting quality of life and independence.”

    Initial clinical trials were carried out on a small number of glaucoma patients and compared with tests on healthy people. The initial clinical trials established the safety of the test for patients.

    Further studies will now be carried out to into DARC and how it can be used not only to diagnose and treat glaucoma patients but also for other neurodegenerative conditions.

    ENDS

    Link to paper: The following link will go live at the time the embargo lifts: https://academic.oup.com/brain/article-lookup/doi/10.1093/brain/awx088
    For embargoed copies of the BRAIN paper and for media enquiries please contact Maggie Stratton: m.stratton@wellcome.ac.uk +44 (0)20 7611 8609/ +44 (0)787 211 2656
    For further information about DARC technology please contact Emma Alam: e.alam@uclb.com +44 (0)207 679 9000/ +44 (0)7896 058667
    About UCL Business

    UCL Business PLC (UCLB) is a leading technology transfer company that supports and commercialises research and innovations arising from UCL, one of the UK’s top research-led universities. UCLB has a successful track record and a strong reputation for identifying and protecting promising new technologies and innovations from UCL academics. UCLB has a strong track record in commercialising medical technologies and provides technology transfer services to UCL’s associated hospitals; University College London Hospitals, Moorfields Eye Hospital, Great Ormond Street Hospital for Children and the Royal Free London Hospital. It invests directly in development projects to maximise the potential of the research and manages the commercialisation process of technologies from laboratory to market. For further information, please visit: www.uclb.com Twitter: @UCL_Business

    About UCL (University College London)

    UCL was founded in 1826. We were the first English university established after Oxford and Cambridge, the first to open up university education to those previously excluded from it, and the first to provide systematic teaching of law, architecture and medicine. We are among the world's top universities, as reflected by performance in a range of international rankings and tables. UCL currently has over 38,000 students from 150 countries and over 12,000 staff. Our annual income is more than £1 billion. www.ucl.ac.uk | Follow us on Twitter @uclnews | Watch our YouTube channel YouTube.com/UCLTV

    About Imperial Hospitals NHS Trust/Western Eye Hospital

    Imperial College Healthcare NHS Trust is one of the largest hospital Trust’s in England, providing acute and specialist healthcare for a population of nearly two million people. The Trust has five hospitals – Charing Cross, Hammersmith, Queen Charlotte’s & Chelsea, St Mary’s and The Western Eye – as well as community services.

    The Western Eye Hospital is a specialist eye hospital in West London with a 24/7 accident and emergency department. The hospital’s facilities also include outpatients, inpatients, day case and inpatient surgery.

    About Wellcome

    Wellcome exists to improve health for everyone by helping great ideas to thrive. We’re a global charitable foundation, both politically and financially independent. We support scientists and researchers, take on big problems, fuel imaginations and spark debate.

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