New research finds 83% of CUES patients retained within primary care in Greater Manchester

The largest evaluation of CUES in England to date also looked at prescribing trends by IP optometrists working within the Greater Manchester service

2 min read

Getty/Ulisberg Alves

Selina Powell

30 July 2026

New research published in Ophthalmic and Physiological Optics has provided analysis of the Greater Manchester Community Urgent Eyecare Service (CUES).

The study found that 83% of the 54,994 patients who were seen through CUES in 2024 were retained within primary care. Patients in the most deprived areas of Manchester accounted for a greater proportion of CUES attendances than patients in the least deprived areas.

In terms of presenting symptoms, a painful red eye prompted 66% of Greater Manchester CUES patients to book an appointment in 2024 followed by flashes and floaters (17%), vision problems (12%) and a foreign body sensation (4%).

The analysis found that around 17% of patients seen through CUES were referred to the hospital eye service, with emergency eye department clinicians in agreement with the referring optometrist’s diagnosis 75% of the time.

The researchers highlighted that among the cases referred to the hospital eye service, 40% of patients could have been managed in primary care if independent prescribing capacity had been available.

Of the 54,994 CUES cases in 2024, a total of 496 cases were managed by a practitioner using their IP qualification.

IP optometrists discharged a significantly higher proportion of CUES patients – at 88% – compared to non-IP optometrists (78%).

IP optometrists issued a FP10 prescription in around three out of every four CUES cases. The most common prescriptions were corticosteroids (accounting for 44% of prescriptions), antibiotics (14%) and antimuscarinics (12%).

The authors highlighted that less than 1% of Greater Manchester CUES cases in 2024 were dealt with by IP optometrists.

They added that increasing this figure could help to reduce hospital referrals – as four in ten referrals made to the HES were deemed suitable for management by an IP optometrist if capacity had been available.

“Addressing barriers to the IP qualification, such as cost and hospital placements, appears key to improving the CUES pathway,” the authors highlighted.