Optometrists in Wales to be able to certify vision impairment for all conditions in adults

Optometrists in Wales will be able to certify vision impairment for all types of eye conditions in adults from 11 June 2025, a joint statement from NHS Wales Shared Services partnership and Optometry Wales has confirmed. 

The move marks a first across the UK and is expected to improve support for people with sight loss, as well as easing pressure on hospital eye departments.

Optometrists in Wales will now be able to assess and certify vision impairment in optometry practices, and in patients’ homes.

Previously, only ophthalmologists could certify all vision impairment. As of May 2023, optometrists with relevant qualifications could issue a certificate of vision impairment (CVI) for patients with bilateral atrophic age-related macular degeneration in Wales.

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The joint statement emphasised that the new approach follows NICE guidelines, ensuring patients with vision loss are supported in a timely and efficient way.

The expanded service will be supported by additional training for optometrists and close collaboration with local authorities, the statement highlighted.

Children and patients who are receiving treatments to improve their vision will still be assessed in hospitals.

Judy Misra, CEO of Optometry Wales, said: “This is a big step forward for patients in Wales. By allowing optometrists to handle more certification, we can reduce delays and free-up hospital resources for patients with more complex needs.”

The change has resulted from a collaboration between Welsh Government, NHS Wales, optometrists, and ophthalmologists, along with support from the voluntary sector who represented the voice of patients.

Rebecca John, national clinical led for Wales General Ophthalmic Services, said: “We’re proud of the optometry profession in Wales. This is another example of how they are leading the way in primary care, thinking outside the box and showing their importance to the modern NHS.”

We’re proud of the optometry profession in Wales. This is another example of how they are leading the way in primary care, thinking outside the box and showing their importance to the modern NHS

Owen Williams, Wales Council of the Blind director, commented: “More patients with sight loss can now be issued a certificate of vision impairment on the High Street or in the comfort of their own home. It’s all about getting patients connected more quickly to additional support in the community.”

Support could include accessing a self-help group, emotional support, fitness and wellbeing opportunities, or help to stay in employment.

Williams added: “There are many ways a patient can be helped beyond medical interventions, and we see the optometrist as a key figure in the process of socially prescribing and referring to other organisations, as well as providing access to additional support, welfare benefits, financial concessions, and services in social care.”

Calls for review to CVI process in England

Last month, the AOP highlighted the need for an “urgent” review of the process for certifying vision impairment in England, calling on the Government to extend the power to certify sight loss to optometrists.

The move followed the results of a survey by the AOP of 1000 optometrists, which found that more than half had frequently seen patients who were eligible for a CVI but did not have one.

Of optometrists surveyed, 86% support the move to allow optometrists to certify vision loss in England.

On the release of the survey results, Adam Sampson, chief executive of the AOP, said: “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.

“The announcement that optometrists in Wales will be able to certify vision impairment for all types of eye conditions in adults shows what we are arguing for is possible. It is critical that in England a review is undertaken urgently to ensure that people are not stranded without essential support.”