Improving Community Diagnosis and Referral of Patients with Papilloedema versus Pseudopapilloedema
- Principal Investigator: Alyson Huntley, Denize Atan
- 1 January 2022 to 31 December 2022
- Project No: 581
- Funding round: FR3
Regular eye tests are important to check on eye health.
When people have an eye test it can pick up serious health problems. Brain tumours can cause swelling of the nerves at the back of the eyes, but as only half the people with this problem have any symptoms early on, an eye test may be the first time it is picked up.
It is sometimes difficult to tell if someone has nerve swelling at the back of the eyes. Special tests can help diagnose nerve swelling. Until recently, these special tests were only done in hospitals by doctors specialising in eye disease; now, they are available at some local optician practices in the community. The problem is that the results of these tests are not always clear or easy to understand by community health professionals (opticians, GPs) so many people are still referred to hospital to check if their nerves are swollen.
In Bristol alone, the number of people sent to hospital has increased by 500-600% in the last 5 years. Many people are referred to hospital by GPs and opticians unnecessarily; they are told they ‘might have a brain tumour’ and upset by the stress and anxiety until they are told they do not. In turn, the increase in unnecessary referrals to hospital means that patients who do have nerve swelling (papilloedema) wait longer for appointments.
Hospitals vary a lot in how they handle these referrals. Now, because of COVID19, waiting times for appointments and specialist tests are even longer.
Our study will find out how local opticians, GPs and hospitals in different areas of England manage referrals of patients with possible nerve swelling behind the eyes. We will find out where more training, equipment or resources in the community might help to improve referrals, reduce waiting times, and the costs to patients and the NHS.
Various professional bodies and health experts have offered to help us with our study. Together, we will make recommendations for guidelines for community screening and referral of nerve swelling at the back of the eyes, educational materials and a website for community health professionals, and patients. Working together with a diverse range of people from the general public and patients with brain tumours, we will produce patient-friendly information to support patients who are referred to secondary care with suspected nerve swelling at the back of the eyes. We will then seek further funding to find out what people think of the guidelines, how we can improve them and develop training materials to help others work with them. We then plan to find out how well the guidelines improve patient care across the country.
Amount Awarded: £80,667