The Prevention Green paper

Our response to the UK Government consultation, October 2019

Optometrist examining patient's eyes

The Association of Optometrists is a membership body for optometrists and other eye health professionals. We represent over 80% of the UK’s 15,000 optometrists.

We welcome the opportunity to provide a response to the Green Paper on prevention. Our response focuses on one question in the Government’s consultation – “how can we make better use of existing assets – across both the public and private sectors – to promote the prevention agenda?”

The importance of sight tests in tackling avoidable sight loss

The Green Paper recognises that sight loss is a serious long-term condition and shows that disease affecting sensory organs accounts for 6% of all long term conditions. However, it does not set out proposals to tackle avoidable sight loss.

More than two million people in the UK live with sight loss, and this number is expected to rise to over four million by 2050. At least 50% of sight loss is avoidable if detected early – so over a million people in the UK suffer from avoidable sight loss.

The impact of sight loss on individuals’ quality of life is huge. Recent research has shown that sight is ranked as the most valuable sense; on average those surveyed said they would prefer 4.6 years of perfect health to 10 years with complete sight loss. 

That’s why it’s vital for the public to understand the importance of sight tests, which are crucial in detecting early signs of eye disease, as well as signs of other health problems. Sight tests in England are mainly performed by optometrists in private sector ‘high street’ settings, although with NHS funding for some categories of patient. We think the Government should do more to promote the health benefits of sight tests to the public.

The role of community optometry in providing follow-up treatment

Sight tests also enable patients with potential eye conditions to access follow-up treatment. However, hospital eye departments are under ever-increasing strain, due to the ageing population and the availability of new technology and treatments. This has led to up to 22 people per month experiencing unnecessary and irreversible sight loss because of delays to hospital appointments. 

This is unacceptable, especially as a solution to ease some of the pressure on hospital eye departments already exists. Optometrists in community practice can provide NHS services to treat minor eye conditions and monitor patients with chronic but stable conditions like glaucoma. These services can free up capacity in hospitals, allowing them to focus on the most complex cases, and are also more convenient for patients than attending a hospital. 

Many areas of England have commissioned these services from optical practices, but provision is patchy across England. In order to prevent avoidable sight loss, the NHS in England must make full use of optical practices by commissioning community eye healthcare services on a wider scale. 

Smoking and eye health 

Most people know that smoking leads to health issues such as cancer and heart disease, but less than a fifth of people know that smoking affects eye health.

In 2019 the AOP launched a campaign to highlight the damaging impact smoking has on eye health. Our campaign, Stub it out, was inspired by our members telling us that they think not smoking is the number one thing people should do to protect their eyes. Smokers are four times more likely than other people to develop age-related macular degeneration, the leading cause of sight loss in the UK, and are twice as likely to develop a condition which can lead to cataracts and glaucoma, which is also sight threatening.

We welcome the Green Paper’s focus on tackling smoking, and the aim of making cigarettes obsolete by 2030. We want to see the Government taking decisive and joined-up action to deliver on these commitments. We liaised with Public Health England this year to promote our Stub it out campaign in parallel with PHE’s successful Stoptober campaign and will continue to promote these important messages about the links between smoking and eye health at every opportunity. We think the Government should also aim to raise awareness of the impact that smoking has on eye health.      

The Association of Optometrists
October 2019