Model of interprofessional collaboration in the care of glaucoma patients and glaucoma suspects.

Patients with glaucoma and glaucoma suspects encompass a large group of individuals—up to 5% of the population over the age of 40 years, and an even higher prevalence in older age groups. With aging of the Canadian population, the number of affected individuals with glaucoma or glaucoma suspects is expected to increase dramatically, placing significant stresses on the resources devoted to eye care. Patients with glaucoma and glaucoma suspects seek eye care from 2 distinct types of trained professionals—ophthalmologists and optometrists. Frequently, the communication between these professionals is less than ideal, potentially leading to duplication of services and tests. Ophthalmologists are medical doctors (MDs) who, after completing 4 years of medical school obtain further specialized training in eye diseases and eye surgery (ophthalmology residency). This specialized training takes 5 years to complete. Some ophthalmologists, after their residency program, will take a further subspecialty training (fellowship) in glaucoma, which can be a 1or 2-year program. These ophthalmologists become glaucoma subspecialists. Comprehensive ophthalmologists are, however, fully trained to manage glaucoma both medically and surgically. For this reason, we do not differentiate between comprehensive ophthalmologists and ophthalmologists with glaucoma subspecialty training in this document. Optometrists take a 4-year program (optometrist school) during which they are trained to carry out routine eye examinations, refractions, and recognition of eye problems, such as glaucoma. Because optometrists are not medical doctors, they are not trained to carry out surgery or any laser procedures. Some optometrists choose to take an additional 6–12 months of training after completing optometry school and, at the end of this additional training, they become “advanced optometrists.” In some Canadian provinces, optometrists are not permitted to prescribe glaucoma medications and in the provinces where they are permitted to prescribe glaucoma medications, different rules and regulations apply. In this document, we decided not to consider whether optometrists are permitted to prescribe medications, but rather opted to describe a model that would be in the best interest of patients. Currently there are no national models or recommendations concerning interprofessional collaboration between