Clinical Study
Eye (2008) 22, 251–255; doi:10.1038/sj.eye.6702593; published online 22 September 2006
A review of glaucoma treatment in Scotland 1994–2004
Meeting presentation: Poster presentation at Glaucoma Society (UK & EIRE) 26th Annual Meeting, Friday 2nd December 2005
S M Macleod1, R Clark2, J Forrest2, M Bain2, N Bateman3 and A Azuara-Blanco1
- 1Department of Ophthalmology, Aberdeen Royal infirmary and University of Aberdeen, Aberdeen, Scotland
- 2Information Services Division, NHS National Services Scotland, Edinburgh, Scotland
- 3Scottish Poisons Information Bureau, Royal Infirmary of Edinburgh, Scotland, Scotland
Correspondence: A Azuara-Blanco, Department of Ophthalmology, Aberdeen Royal infirmary and University of Aberdeen, Foresterhill Road, Aberdeen AB25 2ZN, Scotland Tel: +44 1224 681818; Fax: +44 1224 849156. E-mail: aazblanco@aol.com
Received 31 January 2006; Revised 9 August 2006; Accepted 9 August 2006; Published online 22 September 2006.
Abstract
Objective
This study evaluated the changing trends in glaucoma management in Scotland between 1994 and 2004.
Methods
A retrospective analysis of national health statistics in Scotland from 1994 to 2004. The Scottish morbidity record was used to collect information on all episodes of trabeculectomy. Data on number of prescriptions were gathered for individual drugs and also for groups of active ingredient. The population likely to have glaucoma (PLG) was calculated from estimates of prevalence in individuals aged 40 years and older, based on published epidemiological studies. The outcome measures were trabeculectomy rates, corrected for population likely to be at risk of glaucoma (PLG), and prescribing volume and cost for glaucoma medications.
Results
Trabeculectomy rates have fallen by 67% from 46 per 1000 PLG in 1994 to 15.4 per 1000 PLG in 2004. Over the same time period, the population likely to be at risk of glaucoma (PLG) increased by 16.6%. The cost of prescribing has increased by 122% over 11 years compared with an increase in number of items per 1000 PLG by 27.5%. In 1994, 
-blockers accounted for 65.2% of prescribed drugs but by 2004 this had dropped to 33%. Since their introduction, the prescribing of prostaglandin analogues has increased rapidly and in 2004, they accounted for 39.4% of prescribed drugs.
Conclusion
The increasing use of prostaglandin analogues has led to an increase in prescribing rates and a rapid increase in cost. At the same time, prescribing of -blockers has declined and trabeculectomy rates have fallen.
