“Urgent” review needed so optometrists can certify vision loss in England, AOP says

An “urgent” review must take place to allow optometrists to certify vision loss in England, the AOP has emphasised.

Patients with vision loss are being “left stranded at one of the most vulnerable times in their life” if they cannot access a Certificate of Visual Impairment (CVI), the association said.

In England, only ophthalmologists are currently able to certify vision loss. The AOP noted that overstretched hospital eye departments and a shortage of ophthalmologists mean that many patients are currently going unregistered.

Over half (55%) of more than 1000 optometrists surveyed by the AOP had frequently seen patients who were eligible for a CVI but did not have one, the association said.

Having a CVI is the first step in the process after a sight loss diagnosis, allowing patients to access essential services and benefits.

The AOP warned that those without a CVI can face a significant decline in their mental wellbeing, with many experiencing depression, anxiety or social isolation.

This can be particularly pronounced for older people, who are more likely to suffer from sight-altering conditions such as glaucoma or age-related macular degeneration.

Older people with vision loss are twice as likely to suffer from depression and many experience higher rates of loneliness and mental distress than the general population, the AOP said.

Currently, 340,000 people in the UK are certified as sight impaired or severely sight impaired – however, the AOP emphasised that this figure may be “a significant under-estimate of the actual number.”

Patients “stranded without essential support"

The vast majority (86%) of High Street optometrists support the move to allow optometrists to certify vision loss in England, the AOP found.

The move would bring England in line with Wales, where optometrists have been able to certify vision loss either in practice or in patients’ homes since 2022.

The call for optometrists and other qualified health professionals to be able to certify sight loss comes during Mental Health Awareness Week (12–18 May), which this year focuses on the theme of community.

The change will lead to more people gaining access to the support, such as referrals to low vision rehabilitation programmes in their communities, the AOP said.

Adam Sampson, chief executive of the AOP, said: “For some time, the AOP has been highlighting cases of patients losing their sight because of delays in hospital eyecare. This research highlights a further cost of the delays.

“The requirement that only an ophthalmologist is entitled to certify sight loss denies people who are newly diagnosed of the very services they need to support them during the first, critical months when they are struggling to come to terms with their condition.”

Sampson added: “The link between vision loss and poor mental health has been known for years. It is appalling that people who have just received a life-changing, often devastating, diagnosis are left stranded without essential support, at one of the most vulnerable times in their life.

“We are calling on the Government to act now to extend the power to certify sight loss to optometrists and other medical specialists so that we can remedy this dreadful situation.”

Read the AOP’s Transforming eye care for older people for better health report online.