Raised Intra Ocular Pressures

Optometric practitioners providing this service to patients who have raised IOP should follow:
    • Patients who are identified as having IOP > 21 mmHg or pressure difference of ≥5mmHg between the eyes (with normal optic nerve head/visual field) from any form of tonometry during a standard General Ophthalmic Services [GOS] sight test/or private sight test will have immediate Goldmann Applanation Tonometry (for this enhanced service normal fields means full fields or a non glaucomatous field loss). If the results from the Goldmann Applanation Tonometry are within normal limits ≤ 21 mmHg the patient should be recalled normally after 12 months.

    • If the results from the Goldmann Applanation Tonometry are > 21 mmHg the patient needs to have a repeat tonometry on a separate occasion 1-2 weeks later. If the results of the second Applanation Tonometer reading are >21mmHg patients need to be referred into secondary care via the GP.

    • If there is a difference in IOP of ≥5mmHg between the eyes then provider should consider whether the second Goldmann Applanation Tonometer is required and referral may be appropriate, or whether there is a reasonable explanation (e.g. surgery to one eye). Patients who are identified as having IOP > 21 mmHg (abnormal optic nerve head/visual field) from any form of tonometry during a standard GOS sight test/or private sight test should be referred into secondary care via the GP.

  • When it is impractical to use a Goldmann Applanation Tonometer (e.g. house-bound) then a hand held Perkins should be used.
    Deliver high quality eye care in a familiar environment to patients registered with a general practitioner within NHS Middlesbrough & NHS Redcar and Cleveland, NHS Hartlepool and NHS Stockton on Tees. 

Agreement paperwork

    Contract [pdf] 

Other details

 

IOP scheme powerpoint (pptx) download


IOP referral refinement form (docx) download


Goldmann Tonometer Calibration check record (xls) download