Table 2 Two examples of summaries of screening specifications representing diversity of provider views
Screen location | Screen operator | Target population | Screen tests | Criteria for screen positive | Diagnostic site for screen positives | Diagnostic assessor | Diagnostic test |
|---|---|---|---|---|---|---|---|
Community (General Practice or optometry, or van in remote areas) | Optometrist or technician | 60 | Tonometry [GAT] + nerve fibre layer imaging [expressed preference for GDx as the nerve fibre layer imaging analysis technology] + perimetry [expressed a preference for Humphrey 24-2 and a strong dislike of FDT] ± anterior chamber depth [UBM]. | Didn't say | Virtual clinic: Information from screen positives read by consultant ophthalmologist | Consultant ophthalmologist [strong dislike of this expert job being done by dedicated technicians, nurses, nurse consultants] | Reading of screen test information and then either discharged, retest or those reading positive referred for full standard care glaucoma work up and decision regarding treatment. |
General Practice health centre | Nurse/technician or GP or self testing | 50 but younger for African Caribbean ethnic groups | Ideally simple visual function test taking 2-3 minutes on laptop computer [Motion Detection Perimetry] and tonometry | Difficult to determine a cut -off threshold for IOP | HES | Expert | Full Glaucoma workup |