• Ocular Hypertension
  • Open-Angle Glaucoma Suspect
  • Chronic Open-Angle Glaucoma
  • Acute Angle-Closure Glaucoma
  • Intermittent Angle-Closure Glaucoma
  • Chronic Angle-Closure Glaucoma


Signs and Symptoms

Ocular Hypertension
  • No symptoms
  • Raised intraocular pressure
  • Normal optic disc and visual fields
Open-Angle Glaucoma Suspect
  • No symptoms
  • Optic disc appearance or pattern of visual field loss suggestive of possible glaucoma
  • Normal intraocular pressure
Chronic Open-Angle Glaucoma
  • No symptoms
  • Rarely blurred or 'patchy' vision
  • Glaucomatously damaged optic disc or glaucomatous pattern of visual field loss
  • Intraocular pressure raised or normal
  • Open drainage angle
Acute Angle-Closure Glaucoma
  • Severe ocular pain, haloes around lights, reduced vision
  • Conjunctival injection, dull corneal reflex, pupil enlarged and poorly reactive to light, raised intraocular pressure (typically more than 40mmHg)
Intermittent Angle-Closure Glaucoma
  • Intermittent blurred vision, ocular pain (mild or severe) +/- haloes around lights
  • Symptoms typically worse in dim light and alleviated by sleep
Chronic Angle-Closure Glaucoma
  • No symptoms
  • Rarely blurred or 'patchy' vision
  • Glaucomatously damaged optic disc or glaucomatous pattern of visual field loss
  • Narrow/closed drainage angle

History and Examination

  • Previous medical history including medications/allergy list and family history
  • BMI
  • Mobility
  • Need for interpreter
  • Previous ocular history
  • Ocular family history
  • Anterior segment examination findings
  • Goldmann intraocular pressure
  • Drainage angle assessment (gonioscopy or van Herricks)
  • Optic disc assessment
  • Visual fields

Red Flags

Symptoms/signs of intermittent or acute angle-closure glaucoma

Intraocular pressure >31mmHg

Urgent Care Services:

Royal Devon & Exeter Hospital: Attend ED


Previous records/information from other providers including:

  • letters
  • optic disc imaging
  • visual fields
  • ocular laser/surgery records


Ocular Hypertension:
  • Repeat intraocular pressure measurement as per OHT refinement scheme
Other conditions described above:
  • Refer to secondary care


Referral Criteria

The referrer must confirm that the patient understands that the purpose of the referral is for assessment to determine appropriate management

Referrals must include a DRSS referral form or Opticians referral form and accompanying information from the GP inclusive of information detailed above

Referral Instructions

e-Referral Service Selection

  • Specialty: Ophthalmology
  • Clinic Type: Glaucoma
  • Service: DRSS-Eastern-Ophthalmology-Devon CCG- 15N

Referral Forms

DRSS (GP) Referral Form

Optician Referral Form

Supporting Information

This guidance has been signed off by NEW Devon CCG

Publication date: January 2017


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