The missing patients

Ophthalmology referrals dropped by 83% following lockdown. How can optometrists prevent COVID-19 leaving a trail of avoidable sight loss in its wake?


Data from NHS Digital has revealed that between the beginning of lockdown on 23 March and the end of May referrals to ophthalmology dropped by 83%.

Across the UK, cataract operations were suspended and the diabetic retinopathy screening programme was paused.

Statistics published by four major UK eye hospital treatment groups revealed that new referrals for wet age-related macular degeneration dropped by an average of 72% in April 2020 compared to April last year.

Behind these numbers are individual patients who may be slowly losing sight and independence.

“We have a lot of patients who have been referred for elective care having to wait for a much longer time as a result of the cessation of surgery,” general practitioner Dr Waqaar Shah highlighted at a Royal Society of Medicine (RSM) webinar on Wednesday (24 June).

“These patients may have anxiety about their condition and they may even be in a situation where their sight is deteriorating,” he added.

Leaving aside the limitations on capacity following COVID-19, there are also concerns that patients are not attending appointments because they are fearful about the risk of infection.

As routine services are offered again, optometrists can begin to assess which patients most require their assistance.

Speaking at the RSM webinar, consultant ophthalmologist, Paul Ursell, highlighted that services are starting to “ramp up” within the hospitals.

“We are starting to deliver cataract surgery and working our way through a stratified approach to our cataract backlog,” he said.

The NHS Confederation has warned that the NHS waiting list could reach 10 million by the end of the year – or possibly higher if there is a second wave of COVID-19 without a viable treatment or vaccine.

Despite sobering waiting list statistics, Mr Ursell said that the COVID-19 pandemic has prompted change within the NHS.

“During the lockdown I think most of us realised it was a little bit like the blitz. We had a war time mentality,” he observed.

Mr Ursell noted that the demands of COVID-19 allowed for faster decision making, with processes that might have previously taken five years in normal times enacted in five days.

“It has been an incredible experience. I don’t think any of us thought we would ever have to go through something like this, both professionally and socially. There have been horrors. But we have come out the other side and I think there will be procedural benefits in the system,” he emphasised.

How will your practice help to ease the burden on secondary care as lockdown eases? OT is keen to hear your thoughts and experiences. Please get in touch.