NICE has updated NICE Guideline (NG) 81 on Glaucoma: diagnosis and management, originally NICE Clinical Guideline 85.

Chronic open angle glaucoma (COAG) is a common condition that can cause blindness, but is usually asymptomatic until it has reached an advanced stage. Approximately 10% of blindness registrations in the UK are attributed to glaucoma and the condition accounts for over one million hospital eye service visits annually.

The scope of the guidance on diagnosing and managing open angle glaucoma has been expanded to include what tests should be carried out by primary eye care professionals to determine if referral to a specialist is necessary.

The update has provided an opportunity to re-evaluate the clinical and cost effectiveness, and indications for treating ocular hypertension (OHT). Changes in the costs of pharmacological treatments, acknowledgement of short- and long-term variations in intraocular pressure, and the uneven relationship between rising pressure and increased risk have allowed a simplification of the indications for OHT treatment. Control of intraocular pressure remains a key objective of the therapeutic approach.

Areas covered by the recommendations in NG81 include:

  • case-finding
  • diagnosis
  • standard practice for all assessments
  • reassessment
  • treatment
  • organisation of care
  • providing information.