An observational study in Angle Closure Glaucoma, sponsored by Moorfields Eye Hospital NHS Foundation Trust. Active, not recruiting at 1 site in United Kingdom. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-02-23.
Sponsored by Moorfields Eye Hospital NHS Foundation Trust · Observational
Increases in the aging population has resulted in increased demand for glaucoma services. Glaucoma is a disease that if untreated, can lead to blindness. This increase and need for long term treatment with monitoring have resulted in a significant demand in the hospital eye service (HES). Many departments are now facing a considerable backlog of outpatient appointments and it's essential that these appointments are reserved for patients who are at risk of glaucoma blindness.
Primary angle closure (PAC) glaucoma is a type of glaucoma, where the drainage route for the fluid inside the eye (known as the angle) is narrowed or blocked. It has been recently identified that approximately half of patients referred into the HES for a suspect narrow angle for further investigation are healthy and are immediately discharged. The exact reasons for these findings are unknown.
This project will investigate clinical decisions by community optometrists who account for the majority of PAC referrals into the HES, as well as assessing their ability to evaluate those at risk of PAC. This project will also examine whether clinical agreement could be improved by providing an educational package.
A clinical image database of angles will be acquired from glaucoma patients attending Moorfields Eye Hospital. A learning package discussing angle closure referral will also be developed. Community optometrists will be invited to complete a questionnaire on their clinical decision making. This will be followed by the vignette assessment, learning package and re-assessment.
If this educational package and/or any other identifiers are found to improve agreement levels, this could reduce the number of referrals and enable community monitoring of those at low risk of developing PAC glaucoma in their lifetime.
91 studies on the registry are indexed under Glaucoma, Angle-Closure; 17 are open to participants now.
This study's enrollment of 163 is below the median of 225 across 32 observational studies indexed under Glaucoma, Angle-Closure.
Browse Glaucoma, Angle-Closure studies →Moorfields Eye Hospital NHS Foundation Trust is the lead sponsor of 48 studies on the registry; 4 are open to participants now.
Counted across the registry records on this site, refreshed daily.
New patients to the glaucoma service will be selected as they would be a real-world reflection of those who have been identified at risk of developing glaucoma that have been referred for glaucoma investigation within the hospital eye service from primary care. Furthermore, they would have an enriched sample of narrow angles that are required to achieve the desired the case-mix required for the image database within the set timelines.
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New patients attending the glaucoma clinic at Moorfields Eye Hospital
Exclusion Criteria:
100 patient participants will be recruited for limbal anterior chamber depth image capture. These images will be used to develop the clinical vignette database
50 optometrists will be recruited to undertake the clinical vignette assessment
Other: Educational package
Online learning package that will discuss the van Herick technique, grading, accuracy and information and discusses the current guidelines for primary angle closure suspect referral.
Agreement of community optometrists on measuring Limbal anterior chamber depth
Levels of agreement and precision of optometrist observers before and after intervention of online educational package in assessment of Limbal anterior chamber depth as a surrogate measure of angle width. Agreement will be measured via an online assessment vignette assessment package. Weighted Kappa statistic and levels agreement will be the outcome measures
Time frame: 12 months
Qualitative outcome measures from optometrists
Questionnaire based outcomes capturing data around current practice, qualifications and training, knowledge and resources available in practice with regards to angle closure diagnosis and referral
Time frame: 12 months
Qualitative outcome measures from patients
Difficulty in performing tests and satisfaction from the appointment (Likert scale 1-10), time taken (minutes) and costs of travel (£) to test site and waiting time to be examined from referral (months).
Time frame: 12 months
Plan to share: No
No publications or documents are linked to this record.
Started Dec 2022 (actual). Primary completion is estimated for Mar 2024, 15 months after the start.
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This study is active, not recruiting, as verified in Dec 2023. You cannot join it, but the record below documents what was studied.
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Moorfields Eye Hospital NHS Foundation Trust