"My Glaucoma care in Devon"

About: Royal Devon & Exeter Hospital (Wonford) / Ophthalmology Tiverton and District Hospital

(as the patient),

My glaucoma has been monitored mostly at Tiverton Hospital and sometimes at the Royal Devon & Exeter West of England Eye Unit since 2005.

Appointments have been made variously by North & East Devon Health Authority; West of England Eye Unit (at R D & E); Mid Devon NHS Primary Care Trust; Devon Healthcare Community; and latterly Northern Devon Healthcare Trust.

Initial laser treatment at the R D & E was not very successful. Since then pressures have been monitored at Tiverton Hospital sometimes by Consultant “A” or Consultant “B” and other times by an Ophthalmic Nurse; An Ophthalmic Specialist Nurse; or an Optometrist.

In October 2010 Consultant “A” advised me to stop using drops that he had previously prescribed as they were causing irritation and recommended something that might be less of an irritant..

Early in 2011 I was seen by Consultant “B” at Tiverton. As the new drops were still causing irritation he prescribed preservative-free drops and recommended that I should try laser treatment again saying that an appointment would be made for this to happen at the R D & E West of England Eye unit. Pressures were measured again at Tiverton (Community Optometrist) in July 2011 but no mention of laser treatment.

A letter was received in September from Consultant “A ” saying that as the pressures remained well controlled drops could be discontinued and recommended an appointment in six months time. No mention of laser treatment. I wrote to Consultant “A” querying this. A reply came via my GP in November saying “that it would appear I had never received an appointment for laser treatment”. He would only intervene if pressures rose above 14mmHg. On the following day I received a letter offering me an appointment for laser treatment. Later the same day a telephone call came from the Consultant’s secretary cancelling the appointment due to an administrative error. This was followed by a letter confirming the cancellation.

I then waited for a six-monthly follow up appointment. As I had been last seen in July 2011 I reckoned this should be January 2012. Towards the end February I received a letter offering me an appointment in April. As I was not having any treatment at all I was understandably anxious to know whether the pressures were being maintained. I rang Tiverton Hospital to see if there was a chance of being seen sooner and they rang back with a cancellation for a few days time.

Pressures were 14/14 and a further appointment would be offered for May (this has been received). The nurse told me that the Ophthalmology department was very much behind with appointments and suggested that in future I should be seen in Exeter. I resisted this saying that I had always been satisfied with the treatment in Tiverton and would prefer to be seen here in Tiverton. My only concern is that I am seen regularly; the nature of glaucoma being what it is and having had an uncle who lost the sight of an eye because of it.

My overall impression is that there seems to be considerable administrative confusion in the department. For instance, I am told that Consultant “A” no longer attends Tiverton Hospital and that yet another Consultant “holds the list”. When I asked about Consultant “B” I was told he doesn’t come to Tiverton any more and yet a friend of mine sees him regularly at the Tiverton Clinic.

I would judge that the staff do seem to be under a great deal of pressure and about lines of responsibility and what is happening. As a patient, I feel that I should clearly understand which individual (consultant) has the oversight of my eye care.

It is natural that Tiverton people do not want to travel to Exeter, especially the elderly who may have other problems as well as eyesight.

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