Clinical Scorecard: Improving Glaucoma Clinic Workflow

At a Glance

Key Highlights

• Virtual reality–based perimetry reduces bottlenecks by enabling in-exam-room testing without dedicated dark rooms or patient repositioning.
• Early use of SLT and MIGS decreases postoperative visits and medication management burden, improving clinic efficiency.
• Incorporation of optometrists and scribes redistributes workload, allowing glaucoma specialists to focus on complex cases and patient interaction.

Guideline-Based Recommendations

Diagnosis

• Utilize virtual reality–based perimetry for visual field testing to reduce patient movement and room turnover.
• Integrate multiple assessments (visual acuity, pupil testing, extraocular motility, color vision) in a single session when possible.

Management

• Implement early selective laser trabeculoplasty (SLT) to reduce reliance on drops and decrease medication-related discussions.
• Adopt minimally invasive glaucoma surgery (MIGS) to lower postoperative visit frequency and resource use.
• Incorporate optometrists to manage stable patients and routine follow-ups under clear chart parameters.

Monitoring & Follow-up

• Use optometrists for intraocular pressure checks and post-laser follow-ups with referral back to specialists if changes occur.
• Employ scribes to document visits and reinforce patient instructions, enhancing clinic flow and patient understanding.

Risks

• Potential for delays if scheduling does not align appointment types with clinic flow, especially early in the day.
• Risk of inefficiency if multiple patients requiring extensive testing (visual fields and OCT) are scheduled simultaneously.

Patient & Prescribing Data

Glaucoma patients undergoing medical and procedural management

Early SLT use can reduce drop dependency, medication adjustments, and related patient-physician communications.

Clinical Best Practices

• Train technicians to administer virtual reality–based perimetry to maximize testing efficiency.
• Reserve early clinic slots for shorter visits such as postoperative checks and intraocular pressure measurements.
• Alternate testing types and minimize duplicate testing to prevent bottlenecks.
• Use dedicated scheduling slots for new patients, urgent visits, and procedures to stabilize clinic flow.
• Clearly define parameters for optometrist-managed care to maintain oversight and appropriate referrals.

References

• 2026 ASCRS Annual Meeting - Improving Glaucoma Clinic Workflow