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In-home Tracking of glaucoma: Reliability, Acceptability, and Cost: the I-TRAC Study

What is I-TRAC?

The main aim of our study is to assess acceptability and feasibility of home monitoring, and to make recommendations about future research to test how the NHS could use home monitoring.

Glaucoma is a common chronic eye condition and the second commonest cause of blindness in the UK. It is typically influenced by the pressure in the eye (intraocular pressure) being too high, for a particular person. Glaucoma impairs mainly the peripheral vision (visual field). Treatments reduce eye pressure to delay or stop glaucoma getting worse. However, in some glaucoma may still progress, so patients need regular monitoring at hospital eye services where they have their eye pressure and the visual field measured.

This allows doctors to assess effectiveness of current treatment and detect glaucoma progression. Patients need these check-ups for the rest of their lives.

Hospital eye services are very busy, accounting for 10% of all NHS outpatient visits. Glaucoma patients represent a significant part of this workload, in England alone over 1 million visits per year are for glaucoma patients. Providing regular surveillance and treatment is already a major challenge for the NHS. The prevalence of glaucoma increases with age. Demand for glaucoma care is increasing (and will continue to do so) due to our aging population.

Recent advances in technology mean it is now possible for glaucoma patients to monitor eye pressure and visual fields in their own home. Their information could be transferred to the hospital for interpretation by a health care professional, or they could request hospital appointment if the home tests show their glaucoma has worsened or eye pressure has increased. Home monitoring could mean patients requiring fewer hospital check-ups, whilst increasing convenience and potentially reducing costs and increase capacity for the NHS.

Currently though, we do not know if home monitoring is acceptable to people with glaucoma, or if home monitoring in the general glaucoma population is feasible.

In our project, 45 patients with glaucoma (15 each from Northern Ireland, Scotland and England) will get home monitoring equipment, an iPad tablet and a home tonometer to do home monitoring tests weekly for 3 months. We’ll train patients to perform the tests and offer
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Funding acknowledgement

The I-TRAC study is funded by the Health Technology Assessment Programme of the National Institute for Health Research