Research

A patient-centered evaluation of Glaucoma Monitoring Services in Primary Care Optometry

Community Glaucoma Services enable the monitoring of patients with glaucoma and related diagnoses in primary care optical practices, offering an alternative to hospital-based care. These services, delivered by accredited optometrists working to clinical management plans, are designed for low-risk cases such as ocular hypertension, suspected glaucoma, or stable early chronic open-angle glaucoma. Previous pilot evaluations have shown these services to be safe and effective, with high patient satisfaction and significant reductions in both patient travel and carbon emissions. This poster presents the first multi-locality, patient-centred evaluation of glaucoma monitoring services, highlighting their impact on patient experience, system efficiency, and environmental sustainability.

Mackley, T., Bhan, A., & Hughes, A. (2025, 5th – 6th November). A patient-centred evaluation of Glaucoma Monitoring Services in Primary Care Optometry [Poster presentation]. UK and Éire Glaucoma Society (UKEGS) Annual Conference, Edinburgh, Scotland. PES-UKEGS-Patient-Centred-Glaucoma-Monitoring-Poster.pdf

Outcomes of Glaucoma Repeat Reading Services (GRRS) in Primary Care Optometry in England from 2021 to 2025

Glaucoma Repeat Reading Services (GRRS) are an integral part of glaucoma referral filtering in primary care optometry, designed to reduce unnecessary referrals to Hospital Eye Services (HES) following routine sight tests. Endorsed by NICE and GIRFT, GRRS aims to minimise false positive referrals by enabling accredited practitioners to repeat key measurements in cases of raised intra-ocular pressure or suspicious visual field defects. While earlier evaluations were limited in scope and dated, this study presents a comprehensive review of GRRS outcomes across 26 Integrated Care Boards in England from 2021 to 2025, offering updated insights into the effectiveness and impact of these services on patient care and system efficiency.

Hughes, A. Mackley, T., & Bhan, A. (2025, 5th – 6th November). Outcomes of Glaucoma Repeat Reading Services (GRRS) in Primary Care Optometry in England from 2021 to 2025 [Poster presentation]. UK and Éire Glaucoma Society (UKEGS) Annual Conference, Edinburgh, Scotland. PES-UKEGS-GRRS-Poster.pdf

Outcomes of Glaucoma Enhanced Referral Services (GERS) based in Primary Care Optometry in England from 2021 to 2025

Glaucoma Enhanced Referral Services (GERS) are a form of glaucoma referral filtering used in primary care optometry following sight tests, aiming to reduce unnecessary referrals to Hospital Eye Services (HES). Recommended by NICE and GIRFT guidelines, GERS enables accredited optometrists to conduct comprehensive clinical assessments for patients with signs suggestive of glaucoma or ocular hypertension. Previous evaluations have demonstrated the effectiveness of GERS in reducing false positive referrals and improving NHS efficiency. This study presents the first large-scale, multi-locality evaluation of GERS outcomes across 13 Integrated Care Boards in England from 2021 to 2025, providing updated evidence on the impact and value of these services for patients and the wider health system.

Mackley, T., Bhan, A., & Hughes, A (2025, 5th – 6th November). Outcomes of Glaucoma Enhanced Referral Services (GERS) based in Primary Care Optometry in England from 2021 to 2025 [Poster presentation]. UK and Éire Glaucoma Society (UKEGS) Annual Conference, Edinburgh, Scotland. PES-UKEGS-GERS-Poster.pdf

Reduction in travel-related carbon emissions using a Single Point of Access and triage service for ophthalmology referrals

This poster, presented by  Amy Hughes, Helen Haslett, Gayatri Nair, Vijay Balaji, Lisa Gibson and Rupesh Bagdai at the Oxford Ophthalmological Congress, highlights how a Single Point of Access (SPoA) triage system in Mid and South Essex reduced travel-related carbon emissions by 49%. By deflecting nearly 20% of ophthalmology referrals to primary care services or returning them to the referrer where secondary care wasn’t needed, the service saved over 7,000 km in travel and 1,320 kg of CO₂e, supporting both greener NHS goals and more efficient patient care.

Hughes, A., Haslett, H., Nair, G., Balaji, V., Gibson, L. & Bagdai. R. (2025, 7th – 9th July). Reduction in travel-related carbon emissions using a Single Point of Access and triage service for ophthalmology referrals [Poster presentation] Oxford Ophthalmological Conference, Oxford, England. Reduction-in-travel-related-carbon-emissions-using-a-Single-Point-of-Access-and-triage-service-for-ophthalmology-referrals-Poster-FINAL.pdf

Impact of commissioned primary care integrated cataract pathways

This poster, presented by Amy Hughes, Wendy Craven and Anna Bhan at the Oxford Ophthalmological Congress evaluates integrated cataract pathways across six Integrated Care Boards in England. The findings show a high cataract conversation rate (91.8%), over 10,000 secondary are appointments saved, 17 tonnes of CO₂e emissions avoided, demonstrating how primary care-led pathways can enhance access, reduce hospital pressure, and support a greener NHS.

Hughes, A., Craven, W. & Bhan, A. (2025, 7th – 9th July). Impact of commissioned primary care integrated cataract pathways [Poster presentation] Oxford Ophthalmological Conference, Oxford, England. OOC-Congress-Poster-Integrated-Cataract-Service-Evaluation.pdf

Outcomes of Glaucoma Enhanced Referral Services (GERS) based in Primary Care Optometry in England from 2021 – 2024

This poster, presented by Tom Mackley,  Amy Hughes and Anna Bhan at the Oxford Ophthalmological Congress, shares outcomes from over 14,000 patients assessed through Glaucoma Enhanced Referral Services (GERS) between 2021 and 2024. Nearly half (49%) were safely managed in primary care, avoiding referral to hospital services. The findings demonstrate the value of GERS in reducing false positives, easing pressure on glaucoma clinics and improving patient flow, supporting national guidance and offering a scalable model for wider adoption across the NHS.