Older people’s eye health and eye care

An increasing concern

The risk of sight loss and eye disease increases with age. The RNIB estimates that by 2035 the number of people in the UK living with sight loss will increase by 27%. This means that an estimated 2.8 million people across the UK will be affected, with one in five experiencing sight loss in their lifetime.

The burden of sight loss

Sight loss can significantly limit activities of daily living, and is associated with an increased risk of depression, suicide, cognitive decline and falls. While many hospitals provide access to support and advice, for example through an eye care liaison officer (ECLO), this is not available to everyone. It should be. Health gaps widen as people get older. Interacting inequalities such as social deprivation, ethnicity, or pre-existing disabilities can make this worse. Social isolation becomes more prevalent and seeking care becomes less likely.

Links to other conditions

Poor eyesight has been linked to both falls and disease. Poor eyesight is a risk factor in falls, which is why assessing vision should be part of falls assessments. Experiencing sight loss is linked to deterioration in mental health but often people are left to cope with no emotional or psychological support. Sight loss is also recognised as a risk factor in dementia, and ensuring people have the right eyewear is essential to maximising their engagement with their environment and reducing isolation.

Cost to individuals and the country

As well as the cost to the individuals, there is a huge financial burden on the NHS. Analysis commissioned by the AOP, Fight for Sight, Primary Eyecare Service and Roche suggests that the cost of visual impairment in the UK is projected to rise from £26.5bn in 2020 to £33.5bn in 2032 (an increase of 26%).

Too few people are receiving the support they are entitled to

340,000 people in the UK are certified as sight impaired or registered blind but this figure is thought to be a significant under-estimate. We believe that optometrists and other qualified health professionals should be able to certify sight loss. This will lead to more people gaining access to the support and benefits that are triggered by having a Certificate of Visual Impairment (CVI).

Too many people are waiting for hospital eye care

The high number of people waiting for planned ophthalmology treatment in England has increased steadily since 2012. Ophthalmology appointments comprise approximately 10% of the entire NHS waiting list with the average waiting time for a first appointment increasing from 5.1 to 8.8 weeks between 2012 and 2020. During the pandemic, it peaked at 13.1 weeks in 2021. It has since reduced slightly but is still significantly higher than pre-pandemic, and represents the highest number of patients awaiting follow-up appointments — more than any other NHS specialty.

People are waiting longer to be seen, and delays in follow-up appointments mean a higher risk of patients suffering permanent visual loss.

Optometrists can do more to help

As well as providing eyewear, optometrists can treat eye disease, help to diagnose illness beyond just eye disease, provide follow-up care and treatment that traditionally takes place in hospitals, as well as provide health advice to people who attend for sight tests. They can also link people into other services. Much of this is already funded in Wales, Scotland and in some parts of England, but most UK patients don’t have access to such care.

References

For a full list of resources used to create this information hub visit our reference page.