Deprivation and NHS General Ophthalmic Service sight testing activity in England in 2022-2023.

Purpose: Socioeconomic deprivation is associated with an increased incidence of sight-loss. To inform potential developments in eyecare, General Ophthalmic Service (GOS) sight-testing activity was explored in relation to deprivation for GOS contractors submitting National Health Service (NHS) claims in England.

Methods: Data on NHS sight-test claims for the financial year 2022-2023 were sought from NHS England (NHSE), including number of sight-tests by GOS contractors, their unique Organisation Data Service codes and postcodes and age-bands of patients accessing sight-testing.

Glaucoma treatment and deprivation: time-series analysis of general practice prescribing in England.

Background: Despite advances in glaucoma management, topical eyedrop treatment has been paramount, with prostaglandin analogues (PGAs) being first-line agents. While late presentation is linked with deprivation, there is no recent research examining associations between deprivation and prescribing within primary care.

Aim: To explore PGA prescribing in general practice over a 6-year timeline, assessing associations with deprivation.

Providing capacity in glaucoma care using trained and accredited optometrists: A qualitative evaluation.

Introduction: The role of optometrists in glaucoma within primary and secondary care has been well described. Whilst many studies examined safety and clinical effectiveness, there is a paucity of qualitative research evaluating enablers and barriers for optometrists delivering glaucoma care. The aims of this study are to investigate qualitatively, and from a multi-stakeholder perspective whether optometric glaucoma care is accepted as an effective alternative to traditional models and what contextual factors impact upon their success.

The PAUL® glaucoma implant: 1-year results of a novel glaucoma drainage device in a paediatric cohort.

Purpose: The PAUL® glaucoma implant (PGI) is a novel glaucoma drainage device, which has not been previously reported in paediatric glaucoma management. This study aims to evaluate the safety and effectiveness of the PGI in a paediatric cohort.

Methods: A retrospective evaluation of 25 cases of paediatric PGI surgery (age 8 months to 16 years) was performed at Manchester Royal Eye Hospital between September 2019 and July 2020.

Surgical technique, perioperative management and early outcome data of the PAUL® glaucoma drainage device.

Objectives: To describe a surgical technique and early post-operative outcomes for a novel glaucoma drainage device-the PAUL® glaucoma implant (PGI).

Methods: A consecutive cohort study of subjects who had PGI surgery between February 2019 and May 2020 with a minimum of 6-month follow-up. Primary outcome measures included failure (intraocular pressure (IOP) > 21 mmHg or a <20% reduction of IOP, removal of the implant, further glaucoma intervention or visual loss to no light perception).

Outcomes of Primary Trabeculectomy From Two Same-centre Cohorts 10 Years Apart.

Precis: Trabeculectomy can effectively lower intraocular pressure (IOP). A more junior surgeon profile is emerging. Mitomycin C (MMC) has replaced 5-fluorouracil (5-FU) intraoperatively with comparable success rates and a decrease in postoperative antimetabolite administration.

Spontaneous Resolution of a Rapidly Formed Dense Cataract Following Nd: YAG Laser Peripheral Iridotomy in a Case of Pigmentary Glaucoma.

A 54-year-old man was referred for a senior opinion. His vision had acutely dropped in his right eye from 6/6 to hand movements following Nd:YAG laser peripheral iridotomy for treatment of pigmentary glaucoma. A dense rosette posterior subcapsular cataract had formed in his right eye rapidly after surgery.

Care pathways for glaucoma detection and monitoring in the UK.

Glaucoma presents considerable challenges in providing clinically and cost-effective care pathways. While UK population screening is not seen as justifiable, arrangements for case finding have historically been considered relatively ineffective. Detection challenges include an undetected disease burden, whether from populations failing to access services or difficulties in delivering effective case-finding strategies, and a high false positive rate from referrals via traditional case finding pathways.

Precipitants of 5-Fluorouracil in Trabeculectomy Bleb Management: A Comparative Laboratory Study.

Aim: Concerns regarding 5-Fluorouracil (5-FU) corneal toxicity have resulted in various ways of reducing its corneal exposure during post-operative trabeculectomy bleb manipulation. This study investigates the properties of various topical agents used to induce the precipitation of this compound.

Materials And Methods: This is a double-blind, descriptive, laboratory study comparing five different potential precipitants of 5-FU (proxymetacaine (proxy), oxybuprocaine (oxy), ametho-caine (ameth), fluorescein (flor), proxymetacaine + fluorescein (proxy-flor) to a control group (normal saline).

Clinical effectiveness of the Manchester Glaucoma Enhanced Referral Scheme.

Background: Glaucoma referral filtering schemes have operated in the UK for many years. However, there is a paucity of data on the false-negative (FN) rate. This study evaluated the clinical effectiveness of the Manchester Glaucoma Enhanced Referral Scheme (GERS), estimating both the false-positive (FP) and FN rates.

Long-Term Outcomes and Complications of Baerveldt Glaucoma Drainage Implants in Adults with Glaucoma Secondary to Uveitis.

This study investigated the efficacy and safety of Baerveldt glaucoma implants (BGI) in adults with uveitic glaucoma (UG) at the Manchester Uveitis Clinic. This was a retrospective study of 42 patients with UG who underwent BGI implantation between 2006 and 2015. Primary outcome measures were intraocular pressure (IOP) reduction and number of medications at 5-year follow-up.

A study to assess the feasibility of undertaking a randomized controlled trial of adherence with eye drops in glaucoma patients.

Background: Adherence with therapy could influence the progression of glaucoma and ultimately affect the onset of visual impairment in some individuals. This feasibility study evaluated the measures to be used for a future randomized controlled trial assessing the effects of group-based education on adherence with eye drops.

Methods: People diagnosed with glaucoma within the previous 12 months attending a regional ophthalmology clinic in the North West of England were recruited.

Relationships between visual field sensitivity and spectral absorption properties of the neuroretinal rim in glaucoma by multispectral imaging.

Purpose: To investigate the relationship between neuroretinal rim (NRR) differential light absorption (DLA, a measure of spectral absorption properties) and visual field (VF) sensitivity in primary open-angle glaucoma (POAG).

Methods: Patients diagnosed with (n = 22) or suspected of having (n = 7) POAG were imaged with a multispectral system incorporating a modified digital fundus camera, 250-W tungsten-halogen lamp, and fast-tuneable liquid crystal filter. Five images were captured sequentially within 1.

Randomized clinical trial to evaluate the effects of Pascal panretinal photocoagulation on macular nerve fiber layer: Manchester Pascal Study report 3.

Purpose: To investigate the effects of panretinal photocoagulation (PRP) on macular thickness and macular nerve fiber layer thickness in eyes with proliferative diabetic retinopathy.

Methods: Single-center, randomized clinical trial (n = 40 eyes). Proliferative diabetic retinopathy was treated with 1,500 burns given as Pascal 20-millisecond single-session PRP (SS-PRP) or as multiple-session PRP (100 milliseconds, MS-PRP) over a 4-week period.

Extension of retracted glaucoma drainage tube using a 22-gauge intravenous catheter in complex pediatric glaucoma.

Purpose: To describe the use of the readily available, sterile, and economical 22-gauge intravenous catheter (Venflon) as a preferable option for extending the tube of glaucoma drainage devices in cases of tube retraction in complex pediatric cases.

Methods: A report of noncomparative retrospective evaluation of 2 pediatric cases with tube retraction treated with the extension of the tube. The tube of the drainage devices (1 Baerveldt and 1 Molteno) was extended using a segment of a 22-gauge intravenous catheter (Venflon).

Technical Note: grading the vertical cup:disc ratio and the effect of scaling.

Purpose: To evaluate the effect of scaling on sensitivity to change for grading the vertical cup:disc ratio (CDR).

Methods: Vertical CDR was assessed by six observers (three ophthalmologists and three optometrists) on 43 stereo disc photographs. Repeated observations were made for both 0.

Influence of cyclical mechanical strain on extracellular matrix gene expression in human lamina cribrosa cells in vitro.

Purpose: The mechanical effect of raised intraocular pressure is a recognised stimulus for optic neuropathy in primary open angle glaucoma (POAG). Characteristic extracellular matrix (ECM) remodelling accompanies axonal damage in the lamina cribrosa (LC) of the optic nerve head in POAG. Glial cells in the lamina cribrosa may play a role in this process but the precise cellular responses to mechanical forces in this region are unknown.

Effect of cyclical mechanical stretch and exogenous transforming growth factor-beta1 on matrix metalloproteinase-2 activity in lamina cribrosa cells from the human optic nerve head.

Purpose: Extensive remodeling of the lamina cribrosa extracellular matrix occurs in primary open angle glaucoma. The transforming growth factor-beta (TGF-beta) and matrix metalloproteinase (MMP) protein families are implicated in this process. The authors investigated (a).