Glaucoma Care Through the LDIM Model
Glaucoma is a complex eye condition that requires careful monitoring and timely treatment to preserve vision. The London District Intercollaborative Model of Care (LDIM) aims to be a streamlined approach that help patients with glaucoma receive the care they need while minimizing wait times and improving access to specialized treatment.
The LDIM model operates through a centralized referral system designed to connect ODs, MDs, and other medical professionals with the appropriate eye care specialists.
Connect with us today to learn how the LDIM model can benefit your patients and help you navigate glaucoma care.
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What Is Glaucoma?
Glaucoma is a group of eye disorders that lead to irreversible damage to the optic nerve, making it the leading cause of irreversible blindness worldwide. Often called the “silent thief of vision,” glaucoma can progress without noticeable symptoms until significant vision loss has occurred.
Although there is no single known cause or cure, there are several known risk factors that eye care professionals are trained to identify. Glaucomatous damage can occur at any intraocular pressure (IOP)—whether high or low—making regular monitoring essential.
The only proven way to reduce the risk of progression is by lowering IOP, which is a modifiable risk factor. This can be achieved through medications, laser treatments, or surgical procedures. Regular testing, including visual field assessments, retinal nerve fiber layer measurements, and IOP monitoring, is critical to detect and manage the condition early.
By working together, patients and healthcare providers can focus on reducing the risk of progression and preserving vision.
Risk Factors & Types of Glaucoma
Several factors increase the risk of developing glaucoma, including:
- Age
- Family history
- Ethnicity
- Medical conditions such as diabetes, hypertension, and heart disease
- Eye conditions like nearsightedness, eye injuries, and more
There are also several types of glaucoma, each with different causes and characteristics.
The most common form of glaucoma, POAG develops gradually and painlessly, causing a slow loss of peripheral vision. It occurs when the eye’s drainage canals become clogged over time, leading to increased IOP.
This type can occur suddenly (acute angle-closure) or gradually (chronic angle-closure). It happens when the iris is very close to the drainage angle in the eye, which can block the drainage canals and lead to a rapid rise in IOP. This is considered a medical emergency and requires immediate treatment.
In this type, optic nerve damage occurs despite normal IOP. The exact cause is not well understood, but it is thought to be related to poor blood flow to the optic nerve.
This type is caused by an underlying condition, such as inflammation, trauma, or the use of certain medications like steroids. It can be open-angle or angle-closure.
A rare form of glaucoma that occurs in infants and young children, usually due to a developmental defect in the eye’s drainage system.
The LDIM Collaborative Approach
The LDIM model operates through:
- Centralized referrals: GPs, ODs, and other medical doctors refer patients with suspected or diagnosed glaucoma to the LDIM program using our centralized fax number.
- Triage & initial management: Once referred, patients are triaged based on the severity and specifics of their condition. Most cases are directed to an OD within the LDIM network.
- Ongoing management: After any necessary surgical or advanced treatment, the patient is returned to their OD for ongoing management and follow-up care.
Benefits of the LDIM Model
By guiding patients through a collaborative network, we can significantly reduce wait times for surgical consultations, helping patients with glaucoma receive timely access to the care they need.
With fewer ophthalmologists available and increasing demand for glaucoma management, the LDIM model helps optimize the use of existing resources.
The LDIM model emphasizes full support and collaboration between optometrists and ophthalmologists. With an integrated approach, LDIM can help provide patients with seamless, ongoing care tailored to their specific needs.
Navigating Glaucoma Surgery
LDIM helps patients navigate and access a range of advanced surgical options to manage glaucoma effectively and preserve patients’ vision.
Our collaborative care model can help patients find and receive the right treatment for their condition through either minimally invasive procedures or more complex surgical interventions.
Minimally Invasive Glaucoma Surgery (MIGS) is a significant innovation in glaucoma treatment, offering safer and less invasive options for reducing intraocular pressure.
These procedures are typically recommended for patients with mild to moderate glaucoma and can include:
- iStent: A tiny device implanted in the eye to help improve fluid drainage and reduce intraocular pressure.
- Hydrus microstent: A small, flexible device inserted into the Schlemm’s canal to help increase the outflow of aqueous humor and lower eye pressure
- Trabecular micro-bypass stents: Devices like the iStent inject and the XEN Gel Stent create alternative fluid drainage pathways, helping to reduce pressure inside the eye.
Trabeculectomy is a traditional glaucoma surgery used for patients with moderate to severe glaucoma that cannot be controlled with medications or MIGS.
It involves creating a small flap in the sclera (the white part of the eye) and a reservoir under the conjunctiva (the clear membrane covering the eye) to allow fluid to drain out of the eye, bypassing the eye’s natural drainage channels.
This procedure helps lower intraocular pressure.
Laser surgeries are often used as an adjunct to medication or other surgical procedures to help control intraocular pressure.
- Selective Laser Trabeculoplasty (SLT): A laser treatment that targets the drainage tissue in the eye to help improve fluid outflow and lower pressure.
- Laser Peripheral Iridotomy (LPI): A laser procedure used to treat angle-closure glaucoma by creating a small opening in the iris, allowing fluid to flow more freely and helping to reduce pressure buildup.
- Cyclophotocoagulation (CPC): A laser treatment that targets the ciliary body to help reduce the production of aqueous humor and lower intraocular pressure, typically used for severe or refractory glaucoma cases.
Information & Referrals
For healthcare providers, our website serves as an educational resource, outlining our model of care and providing the necessary information for referrals. Our centralized fax number for referrals simplifies the process, confirming that patients are triaged and managed efficiently.
For patients, our website is an informational landing spot where you can understand the referral process and know what to expect from your care journey. We provide links to additional resources for those seeking more information about specific conditions or treatments.
Streamlined Glaucoma Management
We are dedicated to providing collaborative, qualified care to help patients manage glaucoma and get timely access to the treatment they need.
For more information about glaucoma and its management or to refer a patient to the LDIM program, please contact us through our centralized fax number.
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More About LDIM
LDIM aims to be a comprehensive resource for patients, optometrists, and family doctors to understand our collaborative approach to eye care.
We offer a centralized fax number to streamline the referral process, allowing easy access to the appropriate specialists. A centralized system helps ensure patients are directed to the right provider quickly, reducing wait times and improving access to care.
Given our population’s changing demographics and trends in specialized eye care, a collaborative approach between Ophthalmologists and Optometrists ensures access to care for all of our patients.
Our platform, through close collaboration between our members, is redefining access to specialized eye care in the London catchment area.
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