Consultant ophthalmologist and glaucoma lead Richard Stead shares how models of care and treatment, from SLT and MIGS to AI, can help decongest NHS hospital eye services.
31st March, 2026
Newmedica has partnered with Optometry Today’s OT Podcast to highlight the innovations reshaping glaucoma and cataract care along with the vital role community optometrists can play in delivering the NHS long term plan, including the 10-year plan for health in England.
Mr Richard Stead, consultant ophthalmologist and glaucoma lead at Newmedica, discusses in this podcast how technology, training and system collaboration can help deliver safer, more efficient care for patients across England.
A significant number of patients currently seen in hospital eye services do not need to be there. If we want to decongest clinics and deliver care closer to home, community optometry is perfectly positioned to take on more with the right training, pathways and support.
Richard Stead
Community optometry: key to relieving pressure on NHS eye services
Mr Stead says glaucoma referral pathways can be complex, vary by postcode, and involve multiple refinement providers. He suggests that with higher glaucoma qualifications and independent prescribing (IP), many low and moderate risk glaucoma patients could be safely managed in community settings. He emphasises the need for:
Two-way communication between optometrists and ophthalmologists
Clear ICB commissioned pathways
Shared imaging and data (OCT, pressures, visual fields)
Recognition of optometrists’ advanced skills.
‘If we build long-term relationships between Newmedica clinics, hospital services and community practices, we can truly move stable care out of hospital,’ Stead notes.
SLT, MIGS and modern glaucoma surgery - options for patients
Mr Stead outlines how the glaucoma surgery landscape has transformed including:
Selective Laser Trabeculoplasty (SLT)
Now recommended as first line treatment in NICE guidance
Avoids adherence issues
Safe, repeatable, effective
MIGS (Minimally Invasive Glaucoma Surgery)
Bypass trabecular meshwork
Can be combined with cataract surgery
Reduce drop burden
High safety profile
Drop-free cataract surgery:
Newmedica provides dropfree cataract surgery, for patients for who it is clinically appropriate. On the podcast, Mr Stead explains the approach.
Benefits:
Reduces need for postoperative steroids drops
Helps patients with dexterity or support challenges
Reduces complexity of recovery
Caveats:
Steroid injections may raise intraocular pressure (IOP) in some patients
Not suitable for all glaucoma patients
Requires community optometrist awareness during post-op checks
Drop-free cataract surgery is a powerful option, but it must be tailored.
Richard Stead
Modern lenses and postoperative considerations
Topics covered include:
Hydrophobic intraocular lenses (IOLs) to reduce posterior capsular opacification
Recognising negative dysphotopsia
Safe lens removal techniques
Listen to the episode
The full podcast episode is available now via the Optometry Today (OT) website
