Page 2294 - Week 06 - Thursday, 6 June 2019

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The CHS Eye Clinic uses a co-shared patient model, whereby Optometrists refer patients in with high or unstable pressures, and the Eye Clinic assesses the patients. Dependent on the underlying cause of the glaucoma, a management plan is put in place. This may involve drops, laser trabeculoplasty, laser iridotomy, cyclodiode laser, ciliary body ablation, Baeveldt implant or surgical trabeculectomy. Where surgery is deemed complex a referral is made to the Sydney Eye Hospital. Patients who fail to respond to CHS Glaucoma management plan and the Glaucoma remains unstable also are referred to Sydney Eye Hospital.

(b) See response to question 1(a).

(2) (a) Open angle and closed angle Glaucoma where community services are unable to deal with the issue, the condition is acute, or requires Tertiary level care.

(b) See response to question 2(a).

(3) (a) Patients with complex eye problems, multiple previous surgeries on the eye, concurrent medical conditions involving the eye with Glaucoma and Glaucoma patients who have failed treatment measures within the Eye clinic’s scope of practice.

(b) See response to question 3(a).

(c) Some patients with Glaucoma are very difficult to stabilise, especially if there are other issues with the eye in question. The Sydney Eye Hospital, which has a much larger service and experience of Glaucoma, is the best place for such patients to achieve the optimum outcome. CHS is a tertiary service, but not an organ specific hospital. There will always be patients that need to be referred to an organ specific hospital to maximise treatment outcomes.

(4) (a) Very few private eye specialists without a public contract would take on surgical treatment of Glaucoma. They would treat patients with drops, and possibly laser trabeculoplasty or laser iridotomy. This relates to lack of specific Glaucoma training, and that these patients require multiple re-visits often to stabilise. In addition some of these patients have very complicated outcomes, which is difficult to manage in a private setting.

(b) See response to question 4(a).

(5) (a)and (b) The only circumstance where this would occur would be a referral from an ACT public ophthalmology specialist to the single ACT contracted VMO ophthalmologist with subspecialty interest in glaucoma surgery for the conditions of acute glaucoma and glaucoma associated with other significant eye conditions. The patient would be treated and managed through the private rooms or as an inpatient at CHS or receive a surgical procedure at Calvary Public Hospital Bruce.

(6) See answer to 5(a).

(7) See response to question 3.

(a) The Sydney Eye Hospital are the specialist referral centre for ACT residents who suffer from complex glaucoma, not treatable by our specialists.

(b) See response to question 7(a).

(8) The cross border funding arrangements and National Health Agreement (NHA) cover referral between hospitals in different jurisdictions. No specific agreement is

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