It is estimated that 300,000 Australians over the age of 40 are currently living with glaucoma, and as many as 50% of these are undiagnosed. This is often despite patients accessing eyecare in the recent past. Due to this, it is expected that an additional 79,000 Australians will develop glaucoma in the next five years, costing the economy $4.3 billion.
Despite progress in the understanding of glaucoma pathophysiology, clinical technology, and optometrists’ training and scope as primary eyecare providers, 50% of Australians with glaucoma remain undiagnosed – a rate that has remained relatively unchanged for the past three decades (see references here, here and here). This is 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 the patient can notice.
Early detection of glaucoma is critical to preserving vision and maintaining quality of life for patients as well as providing a more cost-effective method to lessen the burden of the disease on the economy. So as a part of its Transforming Eye Health strategy, Specsavers has collaborated with key industry stakeholders to implement several initiatives within its practices to detect and refer those with undiagnosed glaucoma.
Following extensive investigation and piloting, Specsavers invested more than $40 million to rollout OCT and related training across its network from 2017. The approach was deliberately to use OCT as part of a standard eye test for all patients, harnessing the clinical benefits of this advanced imaging technology to enhance detection of asymptomatic and early stage eye disease. OCT is used as a supplementary test for glaucoma diagnosis by optometrists rather than a case-finding tool and its systematic use on all patients has already resulted in an increase in glaucoma detection across the Australian population.
Consistent application of OCT as part of the optometric consultation, together with Optometry Benchmark Reporting, clinician education and adherence to the RANZCO Referral Pathways has been effective in increasing the rate of glaucoma detection in line with published prevalence rates for the condition. The graph below shows glaucoma detection rates as measured in 2019.