The Journal of Glaucoma published a peer reviewed article1 featuring Specsavers’ glaucoma data showing that optometrists employing OCT as a routine clinical tool have a higher chance of referring patients for specialist glaucoma management than those without OCT.
Specsavers Clinical Services Director Dr Ben Ashby says the findings in the article have been known and shared by Specsavers ever since the company made the decision to roll out OCTs into each of its practices in 2016, but this is the first time they were peer reviewed.
“We started with a pilot that had the specific objective of targeting the 50% of patients with undiagnosed glaucoma as reported in the Blue Mountains Eye Study2 and the National Eye Health Survey3. This rate had remained relatively unchanged for three decades, primarily due to the nature of glaucoma with a lack of overt signs and symptoms in early stages, and with functional deficits often preceded by extensive structural damage before they manifest in a way that the patient can notice.
“When we started using OCT technology consistently, in conjunction with the RANZCO Referral Pathway for Glaucoma Management and the other assessments included in an eye test, we saw an enhanced detection of glaucoma and were able to refer patients at earlier stages than before. We’ve been utilising the technology in this way with every patient in Australia and New Zealand ever since,” said Dr Ashby.
In fact, according to the peer‑reviewed article,, the practices that utilised OCT consistently referred 1.1% of their patients for glaucoma, compared to practices without OCT who referred 0.8% of patients.
Ophthalmologist feedback in the article found 41% were diagnosed with glaucoma, 38% were considered to be glaucoma suspects, and no sign of glaucoma was detected in 21%.
Ashby says that he hopes that by sharing the data through such a well‑regarded international scientific journal, many practitioners will follow Specsavers’ lead and employ the same glaucoma detection techniques, leading to earlier detection rates for patients everywhere.
“The peer‑reviewed article showcases a proud moment in time, but a lot more has happened since then. We are deeply honoured that so many people trust us to care for their eyes and we’ve been sharing our data and findings with as much of the industry as possible, advocating for the benefits of using OCT in this way.
“We are also very thankful for the wider teams at CERA, the University of Melbourne, the University of Western Australia and Harvard Medical School who contributed greatly to the peer‑review article especially as it was going through its rigours. It was a privilege to work with such a team,” said Dr Ashby.
Data over and above the article
While the peer reviewed data focuses on patients seen in 2019, Dr Ashby explains Specsavers has never left its mission to provide best care for Australians and New Zealanders with both diagnosed and undetected glaucoma.
Ashby says that he hopes that by sharing the data through such a well‑regarded international scientific journal, many practitioners will follow Specsavers’ lead and employ the same glaucoma detection techniques, leading to earlier detection rates for patients everywhere.
Since 2019, glaucoma referral rates have continued to increase, while still maintaining internationally published prevalence rates. In conjunction with systematic use of OCT, Specsavers has implemented a number of initiatives and processes that have led to further detection improvements.
“The implementation of OCT was just the beginning of our journey. Since then, we’ve been constantly looking for ways to improve our detection rates and our results are testament to this. We have implemented a wide range of in‑ and out‑of‑store processes to help optometrists detect glaucoma. These include same‑day visual field processes, integrating OCT directly with the practice management system and networking visual field analyzers and other equipment, glaucoma‑specific recalls, electronic therapeutic prescribing, weekly glaucoma outcome reporting for every practice to drive continuous individual improvement, and a team of Clinical Performance Consultants and inclusion of glaucoma diagnosis and management both in optometrist inductions and in our ongoing local and national CPD program to support optometrists.
“Even with COVID‑19 restrictions leading to decreased patient volume numbers, the percentage of patients that we’ve referred for glaucoma has continued to increase year on year.”
Glaucoma Australia
With an increase in glaucoma detection and referrals from Australia’s largest optometry provider, it is no surprise that Glaucoma Australia has also seen a significant increase in the number of patients it has supported since 2015.
Glaucoma Australia’s patient education and support program, SiGHTWiSE, was set up to equip Australians with glaucoma with the skills, knowledge and confidence to take an active role in their ongoing glaucoma management.
A survey into the effectiveness of the program showed that 84% of patients who take part in SiGHTWiSE adhere to their prescribed treatments, and 91% of patients in the Program attend their recommended appointments1 – both important indicators for management success.
Specsavers is currently looking into is how to increase referral rates to Glaucoma Australia to ensure all patients with diagnosed or suspected glaucoma have the opportunity to receive its important services.
Dr Ashhby says: “Glaucoma Australia is like an extension of care for optometrists and can really make a difference once a patient has left the testing room. Their team works closely with patients to understand their situation and to eliminate any concerns or factors that might impact on the patient receiving future care or treatment.
“Supporting our patients in their holistic eye health journey is important to our optometrists. We are committed to providing best care for patients with glaucoma and are looking at how we can increase referrals being sent to Glaucoma Australia,” said Dr Ashby.
Glaucoma just the beginning
While Specsavers has committed a great deal of time and resource into enhancing eye health outcomes for people with glaucoma, it is also committed to protecting vision from other eye conditions and supporting patients at all levels of their eye health journey.
At Specsavers Clinical Conference last year, Dr Ashby announced that its work as co‑founder of KeepSight has seen Specsavers optometrists refer more than a million appointments to the program which has increased the likelihood of patients with diabetes returning for eye tests in a timely manner by 20%.
“Our work with Macular Disease Foundation Australia helped to formulate their Eye Connect patient support program. We’re also working more holistically with all patient support bodies and have created a network that is connected with the ambition of working together to collaboratively come up with patient‑centered solutions to address shared problems,” Dr Ashby said.
Paul, J. P., McGuinness, M.B., Ashby, B.D (2023) Increased glaucoma case‑finding through routine optical coherence tomography in optometry practice. Journal of Glaucoma 28 November 2023. DOI: 10.1097/IJG.0000000000002339.
Mitchell, P., Smith, W., Chey, T (1997) Open‑angle Glaucoma and Diabetes: The Blue Mountains Eye Study, Australia. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0161642097302474
Keel, S., Xie, J., Foreman, K. Prevalence of glaucoma in the National Eye Health Survey. Available at: https://bjo.bmj.com/content/103/2/191.abstract