**1. Introduction**

Glaucoma is the leading cause for irreversible visual loss worldwide [1]. Periodic assessments are necessary to detect progression at an early stage and to adjust treatment in order to prevent further damage. Once diagnosed with glaucoma, even when asymptomatic, the patient requires lifelong management [2].

The prevalence of glaucoma is expected to increase. The elderly population is growing, and the prevalence of glaucoma increases with age [3]. Advances in diagnostic technologies also allow for earlier detection [4–6]. Furthermore, in the case of the UK, the National Institute for Health and Care Excellence (NICE) released guidance on the diagnosis and management of glaucoma [7], which resulted in an increase in the total number of referrals to hospitals [8,9]. Many hospital eye departments fear capacity problems, since the increase in newly diagnosed cases is not followed by a proportional increase in the number of ophthalmologists [10–12]. Ophthalmologists will be obliged to stretch the time intervals between follow-up (FU) appointments, with the risk of not detecting glaucoma progression early on [13]. Moreover, patients with a known higher risk of blindness will be prioritized, thereby reducing access for new patients [14].

**Citation:** Simons, A.-S.; Vercauteren, J.; Barbosa-Breda, J.; Stalmans, I. Shared Care and Virtual Clinics for Glaucoma in a Hospital Setting. *J. Clin. Med.* **2021**, *10*, 4785.

https://doi.org/10.3390/jcm10204785

Academic Editors: Miriam Kolko, Barbara Cvenkel and Kyung Chul Yoon

Received: 29 August 2021 Accepted: 13 October 2021 Published: 19 October 2021

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**Copyright:** © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

One solution is to increase the number of ophthalmologists, which is not feasible in most cases [15]. Another solution is to increase efficiency; studies have identified both shared care (SC) and virtual clinics (VCs) as alternative methods offering a safe, efficient and accepted framework for glaucoma care [16]. For the care of other chronic diseases, such as asthma [17] or diabetes [18], SC schemes have already been demonstrated to be safe, cost-effective and acceptable. VCs have been demonstrated to be beneficial in the care of suspected melanoma [19] and chronic kidney diseases [20].

The aim of this paper was to review the existing literature concerning SC and VCs running in a hospital-based setting. For each scheme, the implementation was investigated, including the role delegation between the different Health Care Providers (HCPs) and the envisioned type of patients. The quality, the productivity and the acceptance of the care delivered were also examined.
