NHS Halton & St Helens is launching a Glaucoma Referral Refinement service in March 2017. All local contractors who see patients registered with a GP in Halton or St Helens can apply to PECM for a contract to provide the service. All contractors who participate will also be able to see patients with a Sefton or Liverpool GP, as the same service is offered in those areas as well

The service will involve repeating tests related to Glaucoma assessment and there will be 3 pathways:

Glaucoma LOCSU 1a:
Where the IOP is found to be over 21mmHg with normal optic discs and fields, the measurement is repeated up to 2 times using Applanation Tonometer. If the IOP remains over 21mmHg, the patient is referred to HES.

Glaucoma LOCSU 1b:
If a field defect is detected after a sight test, the field is repeated. If the second field further raises suspicion of glaucoma the patient is referred to HES.

Glaucoma LOCSU 1c:
If a non-participating practice refers a patient to a participating one, they will undertake Optic Disc assessment, Fields and Applanation Tonometry. After considering all factors, the participating practice will decide if the patient needs to be referred to HES or reviewed again.

Documents required for the service can be downloaded on this page:

• Launch Presentation
• Instruction Video for Webstar software
• Service protocol
• Patient questionnaire

Related Files: