Initial experience in self-monitoring of intraocular pressure.

Background/aims: Diurnal variation in intraocular pressure (IOP) is a routine assessment in glaucoma management. Providing patients the opportunity to perform self-tonometry might empower them and free hospital resource. We previously demonstrated that 74% of patients can use the Icare® HOME tonometer.

Success of trabeculectomy surgery in relation to cataract surgery: 5-year outcomes.

Aims: To compare success proportions at 5 years in three surgical groups: group 1, trabeculectomy alone; group 2, trabeculectomy followed by cataract surgery within 2 years; and group 3, trabeculectomy performed on a pseudophakic eye.

Methods: A retrospective cohort study. 194 eyes of 194 patients were identified with at least 5 years' follow-up post trabeculectomy (N=85, 60 and 49 in groups 1, 2 and 3, respectively).

Glaucoma Control Strategies in Sub-Saharan Africa: A Review of the Clinical and Health Economic Evidence.

Purpose: A review of the effectiveness, costs, and cost-effectiveness of detection and treatment strategies for glaucoma control in Sub-Saharan Africa (SSA) was conducted.

Methods: Detailed searches were performed using the Ovid Medline, Ovid Embase, The Cochrane Library, Web of Science, Scopus, and LILACS databases up to September 2016. The key Medical Subject Heading search terms used included glaucoma, diagnosis, treatment, effectiveness, costs, cost-effectiveness, and Sub-Saharan Africa.

Phacoemulsification compared with phacotrabeculectomy surgery: a within-person observational cohort study.

Aim: To compare reduction in intraocular pressure (IOP) and gain in visual acuity (VA) following phacotrabeculectomy (PT) and phacoemulsification(phaco) in Tanzanian patients with primary open angle glaucoma(POAG).

Setting: CCBRT Hospital, Dar es Salaam, Tanzania.

Design: Within-person observational cohort study.

Risk factors for bleb-related infection following trabeculectomy surgery: ocular surface findings-a case-control study.

Purpose: Bleb-related infection (BRI) is a devastating complication of trabeculectomy surgery. The aim of this study was to identify ocular risk factors for BRI with specific emphasis on ocular surface parameters. It has been suggested that the frequency has increased since the introduction of antimetabolites, particularly mitomycin C.

Pre-control relationship of onchocercal skin disease with onchocercal infection in Guinea Savanna, Northern Nigeria.

Background: Onchocerca volvulus infection can result in blindness, itching and skin lesions. Previous research concentrated on blindness.

Methods: A clinical classification system of the cutaneous changes in onchocerciasis was used for the first time in this study within the context of an early ivermectin drug trial in the savanna region of Kaduna State, northern Nigeria.

Evaluation of a new rebound tonometer for self-measurement of intraocular pressure.

Background/aims: To compare the accuracy of self-obtained, partner-obtained and trainer-obtained measurements using the handheld Icare Home rebound tonometer with Goldmann applanation tonometry (GAT), and to evaluate the acceptability to subjects of Icare Home measurement.

Methods: 76 subjects were trained to use Icare Home for self-measurement using a standardised protocol. A prespecified checklist was used to assess the ability of a subject to perform self-tonometry.

Are Eye Clinics Safe For The Road? An Observational Report.

We report an observational study, based on the examination of 319 medical records, identifying the proportion of patients whose driving status was documented on the first and subsequent glaucoma clinic visits. We also established the proportion of patients with documented Driving and Vehicle Licencing Agency (DVLA)-related advice when they did not meet driving standards based on their visual acuity and/or visual fields (VF). On presentation, driving status was assessed in 61% (n=195) patients.

Noncontact Screening Methods for the Detection of Narrow Anterior Chamber Angles.

Purpose: Comparing diagnostic accuracy of biomicroscope techniques (van Herick and Smith's tests, evaluating limbal and central anterior chamber depth, respectively) and advanced imaging (Visante OCT and Pentacam) for detection of gonioscopically narrow anterior chamber angles (ACAs).

Methods: A total of 78 subjects with narrow or open ACAs underwent four index tests, performed on both eyes by examiners masked to other test results. Diagnostic performance was compared with gonioscopy, using International Society of Geographical and Epidemiological Ophthalmology (ISGEO) definition of primary angle closure and a classification based on clinical opinion of occludability.

The impact of postgraduate training on UK optometrists' clinical decision-making in glaucoma.

Purpose: To investigate the impact of a postgraduate training module on optometrists' clinical decision-making in relation to the diagnosis and management of primary open-angle glaucoma.

Methods: A group of United Kingdom community optometrists (n = 53) were assessed immediately before and again 3 months after completing a 3-day didactic postgraduate university module on the diagnosis and management of glaucoma. A smaller control cohort (n = 20), who did not receive the intervention, was recruited and completed the same assessments on two occasions, separated by approximately 3 months.

Changing trends in the incidence of bleb-related infection in trabeculectomy.

Aim: To investigate the incidence of late onset bleb-related infection (BRI) following Mitomycin C (MMC) augmented trabeculectomy procedures at a single institution.

Methods: This was a retrospective case series analysis of late onset BRI, defined as either blebitis or endophthalmitis occurring at least 1 month following a glaucoma filtration procedure. Data collected from hospital charts included the position of the conjunctival flap base.

Does optometrists' self-reported practice in glaucoma detection predict actual practice as determined by standardised patients?

Purpose: Questionnaires are commonly used as a proxy measure of clinical practice; however their application in a variety of healthcare settings has found significant self-reporting bias. The aim of this study is to estimate the validity of self-reporting as a measure of optometrist case-finding practice for glaucoma and the appropriate referral of suspects.

Methods: Two complementary approaches were used: (1) a sample of optometrists (N=34) on an ophthalmic list in West London were visited incognito by Standardised Patient (SP) volunteers aged over 54 who were trained to identify the components of a standard Sight Test.

Evaluation and calibration of a binocular infrared pupillometer for measuring relative afferent pupillary defect.

Background: Binocular infrared pupillometry allows an estimate of the relative afferent pupillary defect (RAPD), designated the pupillometric RAPD (pRAPD). We calibrated the pRAPD of a commercially available pupillometer against neutral density filters (NDFs) of known attenuation. The performance of the pupillometer using its own proprietary algorithm is assessed and compared to that of alternative algorithms.

NICE - impact on glaucoma case detection.

Aim: To investigate the impact of publication of the National Institute of Clinical Excellence (NICE) guidelines ('Glaucoma: diagnosis and management of chronic open angle glaucoma and ocular hypertension') in April 2009, on the referrals for suspect glaucoma to Moorfields Community Eye Clinic (MCEC) at Ealing Hospital.

Methods: The clinical data from all optometrist initiated referrals for suspect glaucoma and ocular hypertension were scrutinised by a Consultant Ophthalmologist for a 2 month period, 6 months after the publication of the NICE guidance. Each was then categorised into the following groups: glaucoma positive; glaucoma suspect; glaucoma negative; ocular hypertension (OHT) requiring further follow up in clinic; ocular hypertension to be followed up by community optometrist; other.

A national survey of diagnostic tests reported by UK community optometrists for the detection of chronic open angle glaucoma.

Purpose: In the UK, the majority of cases of chronic open angle glaucoma are detected by community optometrists following a routine sight test. However, there is potential for variability in case finding strategies used. The aim of this study was to carry out a national web-based survey to determine current diagnostic tests used by optometrists in glaucoma case finding.

The silent enemy: a review of cataract in relation to glaucoma and trabeculectomy surgery.

Glaucoma is one of the leading causes of blindness worldwide. In the UK, the estimated prevalence of open angle glaucoma ranges from 0.3% in the 40s to 3.

Barriers perceived by UK-based community optometrists to the detection of primary open angle glaucoma.

Purpose: This paper aims to identify the barriers to case-finding for primary open angle glaucoma (POAG) as perceived by community optometrists in the United Kingdom (UK).

Methods: An anonymous, online survey to investigate the current mode of optometric practice for the detection of POAG was developed. The survey included a free-text question relating to barriers to case-finding for the disease.

A survey of patients attending an eye clinic in Ghana.

To determine the motivation behind patients attending hospital eye services, 30 in-depth interviews were conducted in Accra, Ghana, using a semi-structured format. Patients were interviewed from five different populations. Discomfort in the eye was the main reason for attending the eye clinic.

Immediate postoperative intraocular pressure measurements after trabeculectomy with releasable sutures.

Background: To assess the practicality of same-day intraocular pressure (IOP) review following trabeculectomy with releasable sutures. It is a prospective observational case series study.

Methods: 40 eyes of patients undergoing inpatient trabeculectomy for glaucoma optic neuropathy.

Central corneal thickness: will one measurement suffice?

Objective: To evaluate the measurement of central corneal thickness (CCT) in a cohort of glaucoma patients over a 3-month period. Measurements were then applied to the criteria described in the Ocular Hypertension Treatment Study (OHTS).

Design: Cohort study.

A simple model to predict the sensitivity to change of visual acuity measurements.

Background: Estimates of test-retest variability (TRV) in the form of a 95% range have been suggested as providing a cutoff value (or "change-criterion") against which measured acuity changes can be judged to decide whether they are indicative of a clinically important change. This approach is based on ensuring that the specificity of the procedure is 95% in individuals with no real change. In an earlier article we investigated empirically the ability of the procedure to detect varying degrees of change (its sensitivity).

Neodymium:yttrium-aluminum-garnet capsulotomy and intraocular pressure in pseudophakic patients with glaucoma.

Objective: To determine the 1- and 3-hour changes in intraocular pressure after neodymium:yttrium-aluminum-garnet (Nd:YAG) capsulotomy in pseudophakic patients with glaucoma and to determine the effect of acetazolamide and apraclonidine on these changes.

Design: Randomized controlled trial.

Participants: Pseudophakic patients with glaucoma requiring Nd:YAG posterior capsulotomy (n = 76).

The effect of optical defocus on the test-retest variability of visual acuity measurements.

Purpose: To determine the effect of optical defocus on the test-retest variability (TRV) of visual acuity measurements in normal subjects.

Methods: Normal subjects underwent repeated visual acuity measurement with optical defocus of 0, 0.50, and 1.

LOCS III examination at the slit lamp, do settings matter?

Purpose: To explore whether slit lamp settings may influence measurements made with the LOCS III grading system. The following were tested using a total of 221 subjects: 1. Test-retest variability (with and without the neutral density filter).