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. Optometrists on the Association of Optometrists (AOP) electronic database were invited to participate. The survey was open for 16 weeks between April and July 2008. Results: A total of 1680 responses was received to the survey, of which 1293 (77%) answered the free-text question relating to perceived barriers. Eighty-eight per cent of these reported one or more barriers to the detection of glaucoma in the community, most commonly: time constraints limiting the options for repeat testing and lack of financial remuneration to perform the additional tests required. Barriers were less frequently reported in Scotland, with 23.4% of optometrists reporting no barriers compared to only 12% in England, 6% in Northern Ireland and 4% in Wales. Conclusion: In general, UK optometrists believed that their ability to detect POAG in the community is hampered by time and financial constraints. However, barriers were significantly fewer in Scotland, where optometrists have different contractual terms of service with the NHS than their counterparts in the rest of the UK.