A survey of attitudes of glaucoma subspecialists in England and Wales to visual field test intervals in relation to NICE guidelines.

OBJECTIVES

To establish the attitudes of glaucoma specialists to the frequency of visual field (VF) testing in the UK, using the NICE recommendations as a standard for ideal practice.

DESIGN

Interview and postal survey.

SETTING

UK and Eire Glaucoma Society national meeting 2011 in Manchester, UK, with a second round of surveys administered by post.

PARTICIPANTS

All consultant glaucoma specialists in England and Wales were invited to complete the survey.

PRIMARY AND SECONDARY OUTCOME MEASURES

(1) Compliance of assigned follow-up VF intervals with NICE guidelines for three hypothetical patient scenarios, with satisfactory treated intraocular pressure and (a) no evidence of VF progression; (b) evidence of VF progression and (c) uncertainty about VF progression, and respondents were asked to provide typical follow-up intervals representative of their practice; (2) attitudes to research recommendations for six VF in the first 2 years for newly diagnosed patients with glaucoma.

RESULTS

70 glaucoma specialists completed the survey. For each of the clinical scenarios a, b and c, 14 (20%), 33 (47%) and 28 (40%) responses, respectively, fell outside the follow-up interval recommended by NICE. Nearly half of the specialists (46%) agreed that 6 VF tests in the first 2 years was ideal practice, while 16 (28%) said this was practice 'not possible', with many giving resources within the NHS setting as a limiting factor.

CONCLUSIONS

The results from this survey suggest that there is a large variation in attitudes to follow-up intervals for patients with glaucoma in the UK, with assigned intervals for VF testing which are, in many cases, inconsistent with the guidelines from NICE.