Search
Home (en v512, web) - {110D559F-DEA5-42EA-9C1C-8A5DF7E70EF9}?.Prefix site search
Close Search

Public health and disease prevention

Optometrists skills and capability have a core role to play in public health and the prevention of disease

Optometrist at practice

Key points

  • Visual impairment can worsen health outcomes for people with long-term conditions, including dementia
  • Patient pathways for older people with the most prevalent long-term conditions rarely incorporate eye examination
  • With relatively small amendments to connectivity between parts of the NHS, optometrists could contribute patient intelligence to trigger interventions in secondary care and help with preventative monitoring.

Comorbidities are rising exponentially in the UK as people are living longer in poor health. Evidence suggests health outcomes are worse with visual impairment and that many long-term conditions have vision as an exacerbation and/or risk factor. Visual impairment is also a known risk factor/exacerbation element for dementia. This is significant as it is estimated that 1 in 14 people over 65 are living with some form of the disease.

Age is a major risk factor for diabetes, and diabetic retinopathy is a common complication that can pose a real risk to sight loss. Diabetes UK estimate that more than 5.6 million people in the UK are living with diabetes and that every year, more than 1,300 people with diabetes have sight loss that could have been picked up and prevented.

Optometrists have expertise and equipment to support diabetes case finding but are not currently a core part of the service. With some enhanced connectivity and joined up patient records, they could provide valuable clinical information on a patients’ diabetes risk, triggering an invitation to screening services, or a GP appointment. Taking it a step further, in the future, screening for diabetes could be commissioned to be delivered in optometry nationally, as is the case for 6 of the 56 Screening Units in England.

Despite all the evidence of causality and corelation, patient pathways for older people with these prevalent long-term conditions rarely incorporate eye examination. With relatively small amendments to connectivity between parts of the NHS, the flow of patient information across systems could be dramatically improved. Optometry could serve patient intelligence to trigger interventions in secondary care as well as being well placed to offer preventative monitoring.

Recommendations 

  1. Better data collection and appropriate sharing of patient records with primary eye care to record and flag wider health risks for older people
  2. Eye examination minimum interval criteria standards should be adjusted to offer free tests annually for everyone with a (relevant) long-term condition
  3. Formally enable optometrists to monitor and support diabetes risk with feedback mechanisms to GP and secondary care in place
  4. Collaborate with charities such as Alzheimer’s UK on dementia risk factors, raising awareness among patients and health practitioners about the need for thorough eye examinations.

References

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

Related content