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Key Points

• Examples of referral refinement schemes include: in the Bristol area, a repeat-measures scheme for suspect glaucoma and OHT, and a post-operative cataract care scheme. Some areas have a MECS scheme that has been rolled out with WOPEC training and helps to triage patients with minor eye conditions and it is hoped there will be future funding for this. Somerset has an Acute Community Eyecare Service (ACES) scheme for eye care management.
  
• The LOCSU website and colleagues practicing in that location are a good source of information about local care pathways.
• Local schemes have evolved where optometrists and GPs can refer to accredited optometrists at centers run by private companies for further assessment and management decisions. These may liaise with ophthalmologists via telemedicine.