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BackgroundA number of authors have documented the decrease in the rate of glaucoma drainage surgery, felt to be owing to increased medical therapy options. There has also been an increase in cataract extraction. The aim of this study was, using the NHS Hospital Episode Statistics (HES), to attempt to confirm these trends and to examine the possibility that these trends are not necessarily independent.MethodsThe HES was accessed for the main glaucoma procedures between 1998 and 2004 and for cataract operations performed over the same time period. Diagnostic data were also extracted from the HES data for glaucoma. Figures for the changes in glaucoma medications were obtained from pharmaceutical data.ResultsOver the period that the data are available, trabeculectomy numbers have reduced by 51%, laser trabeculoplasty by 60%, and laser peripheral iridectomy (PI) by 30%. Cataract extractions have increased by 52%. Medical treatments, especially prostaglandin use, have increased. The number of admissions for acute glaucoma did not increase.ConclusionsThe figures indicated a decrease in glaucoma drainage surgery and an increase in cataract extraction—consistent with other studies. More surprisingly, there was no increase in diagnosis of angle closure glaucoma or laser PIs within the figures and we suggest this may in part be related to the increase in cataract extraction. We speculate that this may also partly be responsible for the reduction in trabeculectomies. Although the HES data are a potentially rich source of information, there are potential inaccuracies in the data, which means interpretations must be made with caution.Eye (2008) 22, 3–7; doi:10.1038/sj.eye.6702458; published online 19 May 2006 [ABSTRACT FROM AUTHOR]

Background; Age related macular degeneration (AMD) causing visual impairment is common, in older people. `Previous studies hove identihed smoking as a risk factor for AMD. However, there' is limited' `information for the older population in Britain. Methods: Population `based cross sectional analytical study based in 49 practices selected to be representative of the population of Britain. Cases were people aged 75 years and above who were visually impaired (binocularacuily <6/18) as a result of AMD. Controls were people with normal vision (6/6:or `better). `Smoking history was ascertained using an interviewer administered' questionnaire. Results: After controlling for potentially confounding factors, current smokers were twice as likely to have AMD compared to non-smokers (odds ratio 2.15, 95% Cl 1.42 to 3.26). Ex- smokers were at intermediate risk `(odds. ratio 1.13, 0.86 to 1.47). People who stopped smoking more than 20 years previously were not at increased risk of AMD causing visual loss. Approximately 28000 cases of AMI) in older people in the'United Kingdom may be uttribUtable'to smoking. Conclusion: This is the largest study of the association of smoking ,and AMD in the British population. Smoking is associated' with a twofold increased risk of developing AMD). An increased risk of AMD, which is the most commonly occurring cause of blindness in `the United Kingdom, is yet another reason `for `people to: stop smoking and governments to develop public health campaigns against this hazard.,, [ABSTRACT FROM AUTHOR]

The performance of community orthoptists was retrospectively assessed in a primary preschool screening programme that has been established in Cornwall since 1982. The outcome of screening was compared between random samples of two birth year cohorts corresponding to the second and fourth years of existence of the screening programme (1980, n = 298 and 1982, n = 300). The mean age at screening was significantly later for the second cohort (4.3 years compared with 4.4 years) but otherwise performance indicators improved in the second cohort. Community orthoptists achieved a sensitivity of about 90% and specificity of 99% during the study. It is unlikely that the more commonly used two tier system of health visitors referring to a community orthoptist could achieve this degree of accuracy. [ABSTRACT FROM AUTHOR]