“We must all work together to find a solution”
A collaborative approach to preventing avoidable sight loss as a result of glaucoma was presented at 100% Optical
31 March 2023
Delegates heard about the value of drawing on the skills of the entire eye care sector in reducing avoidable sight loss during a Specsavers presentation at 100% Optical (25–27 February).
Specsavers clinical services director, Giles Edmonds, highlighted: “We are going to share with you our comprehensive vision for what optometry must do to meet the needs of patients with glaucoma.”
Setting out the broader context to the discussion, Edmonds highlighted that disruptive forces, such as the war in Ukraine and the lasting effects of COVID-19, have created uncertainty within the political landscape.
He shared that the ‘Doomsday Clock’ is currently at 90 seconds to midnight – the closest it has ever been to a global disaster.
Edmonds observed that it looked likely there would be a change in government at the general UK election in 2024.
He made reference to the renegotiated Welsh eye care contract, which would see more eye conditions monitored and managed within primary care optometry.
There are 7.2 million people on waiting lists in the UK, up from six million last year, while within ophthalmology alone there are more than 650,000 incomplete referral pathways.
“We must all work together to find a solution for the benefit or our patients and our communities,” Edmonds emphasised.
Edmonds also touched on economic forces – such as the cost-of-living crisis and rising interest rates.
In terms of social forces, Edmonds highlighted that there has been a rise in virtual consultations following COVID-19.
Disruptive forces within technology, such as those created by artificial intelligence technology, are going to create new competition both inside and outside the sector, Edmonds predicted.
“Working together we can shape the future and ensure that optometry plays a greater role in the eye care of our patients,” he said.
Chair of Glaucoma UK, Professor Anthony King, shared with delegates that many people who have glaucoma are not aware of it.
He noted that 2% of people over 40 have glaucoma, while half of those cases are undiagnosed.
“The reality is that the way that glaucoma is diagnosed is very much on an opportunistic case detection basis,” he said.
King added that glaucoma is often detected in primary care by optometrists. He shared that there will be a growth in demand for glaucoma services as the population ages.
King highlighted that the longer someone has glaucoma during their lifetime, the more likely it is that they will require interventions other than eye drops – such as surgery.
Delays in glaucoma treatment increase the risk of sight loss, while there are also costs associated with supporting patients who are registered blind.
“On multiple levels, this should be avoided,” King said.
During COVID-19, King outlined how virtual clinics enabled clinicians to see around 2.5 times as many patients as an equivalent face-to-face clinic.
“Not all patients are suitable for these clinics, but it is certainly one of the solutions we are adopting,” he said.
King highlighted the potential of risk stratification within glaucoma care – so the patients who are at risk of sight loss are the ones who are seen first.
He also emphasised the importance of detecting cases of early glaucoma and ocular hypertension (OHT), as it is estimated that around 5% of the population over 40 have OHT.
King shared that when glaucoma services are established it is important to have leaders who are experienced in the field.
“The key is developing effective healthcare teams. You have to have the right people doing the right job and you have to be prepared to pay for it,” he said.
King observed that glaucoma services are “patchy” across the UK.
“One of my bugbears is the inconsistency in the development of referral refinement services,” he said.
Specsavers director of professional advancement, Paul Morris, emphasised the importance of optometrists engaging with their local community to raise the profile of eye health.
“Optometry as a profession is far too humble. We should make people aware of the risks of not looking after your eye health – there is a lot of need for your expertise,” he said.
He recommended that optometrists ask whether everyone in the family is receiving eye care – not just the patient attending the appointment.
As well as asking whether anyone in the family has glaucoma, Morris recommends checking whether those who do have glaucoma have access to the services that they need.
“This is where you can sign post people to services,” he said.