The State of the UK's Eye Health 2021 - Specsavers
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
The State
of the UK’s Eye
Health 2021
1
2
Contents
Summary 4
Acknowledgements 4
Foreword 5
UK risks a vision crisis 6
The high cost of lost vision due to COVID-19 8
Tackling a nationwide emergency 10
Putting families first 13
Living well in later life 16
Sue Perkins’ story 18
Looking to the future 19
Collaborating to save sight 20
Developing tomorrow’s experts 24
Digital innovation 25
A final word 27
Research method 28
Life-changing community optometry 31
References 33
The State of the UK’s Eye Health 2021 3
Summary
In response to the pandemic, eye care services in the UK were
withdrawn, reduced or restricted. This led to millions of missed
eye tests, delays in treatment and extended waiting times for
patients. The huge backlog will require additional time and
resources to clear, resulting in substantial costs for our health
and social services in years to come. Most importantly, sight
threatening conditions that were not identified and managed
in a timely way may have led to vision loss and even blindness.
Specsavers commissioned Deloitte Access Economics to
quantify the scale of these issues. This report presents
the alarming results of this research and recommends
the entire eyecare sector works together so that
patients are treated at the right time,
in the right place, by the
right professional.
Acknowledgements
We would like to thank Clive cognitive and mental health. Vision and Hearing Support,
Griffiths, David Gibbons, Vista, Warwickshire Vision
Debora Krut, Olwyn Mason, Thank you to all at Glaucoma Support and Wilberforce
Pam Humphries, James Bell- UK and Chair, Professor Philip Trust, who worked with us to
Taylor and his daughter Sofia Bloom, for sharing your identify the backlog in sight
for sharing their stories. Their experiences of supporting impairment registrations.
experiences motivate all of people with glaucoma and
us to deliver the very best working with us on data- We appreciate the support,
patient care. sharing to raise awareness of advice and comment from all
the need for early detection. of our eye health colleagues
The coronavirus pandemic Thanks also to Visionary, the who have contributed their
has had catastrophic effects umbrella body for local sight expertise to this report.
on older people’s lives. We are charities, especially Visionary Together we can do so
grateful to Age UK for helping members Bury Blind, much more.
us highlight the mounting Galloway’s, Ness, seescape,
evidence that sight loss has Sight Action, Sight for Surrey, Report author
implications for physical, VisionPK, Vision Support, Dr Philippa Simkiss
The State of the UK’s Eye Health 2021 4
Foreword
Throughout the pandemic, so many of us in eye health
services have worked hard to provide urgent care to those
who have needed it. Initially, community optometry was
required to severely restrict services, causing a reduction
in referrals to hospital. Almost all routine testing in hospital
eye services stopped and we dealt with emergency and
urgent cases only. We developed risk assessments so
that we could give care to those who needed it most.
As restrictions began to ease, requirements for social
Professor Philip Bloom, distancing and other means of infection control meant that
consultant ophthalmic we all saw far fewer patients.
surgeon and Chair of
Glaucoma UK This has caused long delays and some patients have been
waiting for more than a year for assessment or treatment.
I am concerned about the huge backlog and that when
people do start coming to see us – and they are still fearful
of doing so – we will uncover a large amount of disease.
While many will not have experienced any disadvantage
from such a delay, sadly for some their condition will have
progressed in a way it would not have done with earlier
intervention and treatment.
We have long needed more patients to be seen in
community optometry practices. The rationale for lockdown
was to prevent hospitals from being overwhelmed. Well, our
hospital eye services are overwhelmed! We must accelerate
the pace of change by scaling up the innovation and
collaboration established during the COVID-19 crisis.
I am greatly encouraged by new models of care that draw
on professional expertise from the entire eye care sector
and the speed at which we have adopted digital health
technologies. Dreadful though this pandemic has been,
when it passes it will leave a seismic cultural change that
may otherwise have taken decades to come into force.
The State of the UK’s Eye Health 2021 5
UK risks a vision crisis
New research[1] paints a devastating picture of the impact coronavirus (COVID-19) has had
on Britain’s vision as the identification and treatment of eye disease was severely delayed.
Hundreds of thousands of people were not referred for important checks because services
were limited and some who were referred were reluctant to attend appointments. These
patients are at increased risk of sight loss.
4.3 43,000 6,133
million The number of people The number of missing
The drop in the number of referred with suspected referrals for diabetic
eye tests delivered in 2020, glaucoma fell by an estimated retinopathy in 2020.
a 23% decline compared to 43,000. Of these around
tests administered in 2019. 2,600 would have been for The remainder are for other
urgent treatment. conditions. In the absence
316,000 10,820
of COVID-19 all of these
patients would have seen an
Referrals to ophthalmology The number referred for ophthalmologist for review
fell by 316,000 in the period wet age-related macular and treatment.
March to December 2020 degeneration (AMD) dropped
compared to the same period by more than 10,820 in 2020. Fewer
in 2019, a 28% decrease[2]. treatments
Ophthalmology outpatient
attendances and day case
procedures declined by
36% and 45% respectively
between March to December
2020 compared to the same
period in 2019[3]. The Royal
‘Congratulations for producing this useful report. College of Ophthalmologists
All organisations in the eye health sector recognise the advised continuation of
need to work together, ensuring that pathways are led anti-VEGF injections
by the highest standards of clinical governance to benefit for AMD.
patients. The vision statement from The Royal College of
Ophthalmologists and The College of Optometrists sets out
how primary and secondary care providers can continue
to develop effective and innovative ways of delivering high
quality patient care to reduce avoidable sight loss.’
Professor Bernie Chang, President of The Royal
College of Ophthalmologists
The State of the UK’s Eye Health 2021 6
UK risks a vision crisis
Community optometrists throughout the UK
are working hard to deal with the backlog of
Evidence shows some cases. There is concern that this will result in
patients did not attend a surge of emergency referrals to hospitals,
[4,5,6] so it was estimated which are already stretched[4,7].
an average of 10% of anti-
VEGF injections for AMD were
delayed. Patients also had to
wait longer for eye surgeries,
such as cataract procedures.
The research shows:
Debora’s story
11,062 ‘Timely treatment
The drop in NHS glaucoma
follow-up treatments given. saved my life’
8,680 In November 2019, Debora a prism lens to help correct
The estimated reduction Krut, a university student, Debora’s double vision, but it
in patients who received was experiencing a sore neck, didn’t help, which is unusual,’
injections for diabetic nausea, vertigo and changes says Ciara. ‘When I used the
retinopathy. in mood. Debora thought volk lens and a slit lamp I
these symptoms were caused could see a swelling on the
6,313 by stress and she just needed optic nerve at the back of
An estimated 6,313 fewer to take more breaks. When the eye, which was a sign of
patients received injections she experienced double vision, papilloedema, usually caused
for wet AMD. Debora called the hospital by an increase in pressure
and was advised to book an around the brain. I tried to
235,000 emergency appointment with reassure Debora as I referred
The estimated number of her community optometrist. her to hospital straight away
necessary eye surgeries She was seen the same day for further examination.’
missed or delayed in 2020. by Ciara Ní Chléirigh. ‘I tried
Debora picks up the
story. ‘Tests later that day
confirmed that I had a brain
2,986 tumour. I had surgery to
remove the tumour followed
Lost vision due to the impact of by proton beam therapy.
Thankfully there is only a very
coronavirus (COVID-19) slim chance of the tumour
Sadly, an estimated 2,986 people have lost vision due to returning. I’m now telling
delayed identification and treatment of eye disease; some everyone to make sure they
are experiencing severe sight loss and even blindness. get their eyes tested.’
The State of the UK’s Eye Health 2021 7
The high cost of As the pandemic eases,
lost vision due to community optometrists
are seeing people who are
presenting with new sight
COVID-19 loss. They include people who
would normally have had an
eye test during the lockdown
Our new research shows: This backlog of services period but were encouraged
is also likely to impose to shield or were reluctant to
significant costs for people leave their homes. In some
£36 with sight-threatening
conditions as they live
cases, their disease is more
advanced and their sight
billion with a greater risk of falls,
fear of (further) vision loss,
loss is irreversible. Some will
need support for the rest
In 2019, before the pandemic, productivity losses and of their lives. This presents
the annual UK cost of sight reduced quality of life while an additional personal and
loss and blindness was waiting. societal cost, far greater than
estimated at £36 billion. the health cost the research
57.2 million days has revealed.
£778.3 million If it takes three years to clear
the backlog, people will wait ‘We have patients who
The cost of sight loss and an aggregate additional 57.2 delayed being seen due to
blindness to the UK healthcare million days for their eye anxiety about COVID-19
system declined by £778.3 surgery. outweighing their concern
million in 2020 due to reduced about loss of vision.’
use of services. £2.5 billion Ali Ganiwalla, community
The estimated additional optometrist in Great
This reduction may have economic cost of sight loss Yarmouth
serious and ongoing and blindness due to the
implications in the coming pandemic between 2021 ‘I have seen many complicated
years, not least for those and 2024. cases of patients following
who have lost vision. severe disease.’
Karan Vyas, community
£1.7 billion optometrist in Corby
The net additional impact
‘We have noticed an increase
on the cost of sight loss
and blindness in the UK in diabetic retinopathy,
between 2020 and 2024 macula holes and wet AMD.’
due to the pandemic. Lindsey Taylor, community
optometrist in Blackpool
The State of the UK’s Eye Health 2021 8
The high cost of lost vision due to COVID-19
Local vision charities and Scotland reduced by 28%, This means that people with
supporting people with comparing the year ending sight loss and their families
deteriorating vision are aware March 2021 to the previous can access services where
of the substantial backlog of year (see p30). Experts and when they need them.
people who would normally anticipate a flood of patients We are hugely concerned
be offered certification with newly presenting sight about the volume of people,
of vision impairment and loss and significant eye probably reaching crisis point,
registration[8]. One charity disease, including those who will need community
reports a 50% drop in whose sight could have been services and hospital eye care.
certifications at their local saved[7,9]. I would urge anyone reading
hospital trust (from 175 to 88) this report to ensure that you
during the pandemic. The total ‘Visionary members from know who your local sight loss
new registrations received throughout the UK provide organisation is and how to
by 11 charities managing the community based support, direct people to them.’
Sight Impairment Register for information and advice to Fiona Sanford, CEO of
17 Council areas in England people living with sight loss. Visionary
Clive’s story
‘Being told I had
advanced glaucoma
was heartbreaking’
While shielding due to health Jason spotted that Clive goes to show why a home
conditions that make him had advanced glaucoma visits service is so vital. ‘While
particularly vulnerable to in both eyes so arranged we were unable to reverse
COVID-19, Clive Griffiths an urgent review at the the damage, our intervention
noticed something was University Hospital of Wales. meant that at least some of
wrong: ‘It felt as if my eye was This and the swift follow- Clive’s vision could be saved.
half filled with water, I could up appointments Jason Much later, this wouldn’t have
barely see out of the bottom completed helped save vision been the case,’ said Jason.
of it. It was terrifying.’ in Clive’s right eye though
sadly not his left. Clive’s story
As Clive was unable to leave
his flat, optometrist Jason
Scaife visited him at home.
The State of the UK’s Eye Health 2021 9
Tackling a nationwide
emergency
‘The pandemic has worsened Transformation Programme, reduce these waits and are
the pre-existing delays Getting it Right First developing plans for more
to eye care and there are Time, The Royal College transformative action. It is
now numerous patients of Ophthalmologists and crucial that all organisations
waiting to be seen. However, College of Optometrists, and and professionals responsible
through the co-ordinated major eye charities such as for or delivering eye care in
work between organisations, RNIB, the National Eye Care England, engage with this
including NHS England Recovery and Transformation work to ensure equitable,
Improvement National Programme has provided timely access to care for all
Eye Care Recovery and clear recommendations, patients.’
which are being put into Melanie Hingorani,
place across the country, to Consultant
Ophthalmologist,
Clinical Lead for the NHS
England Improvement National
Eye Care Recovery and
Transformation Programme
The State of the UK’s Eye Health 2021 10Tackling a nationwide emergency
Scotland Wales
‘In Scotland, opticians worked ‘Despite the initial challenges
to care for their patients, at the start of the pandemic, In line with strategic
offering remote services for the Wales Eye Care frameworks, all COVID-19
emergency and essential care Service has delivered some response work was
throughout lockdown. This tremendous innovation. undertaken with a co-
ensured vital eye care was For example, in Cardiff ordinated primary and
available to all throughout the optometrists qualified in secondary care approach to
pandemic. The establishment Independent Prescribing set ensure that demand was met,
of Emergency Eyecare up a service to diagnose, where possible, in the most
Treatment Centres (EETCs) manage and treat patients appropriate clinical setting.
meant that emergency in the community presenting
patients were able to be with conditions that would Northern Ireland’s Health and
seen when not able to be have been directed straight Social Care Board (HSCB)
managed remotely. to Eye Casualty, seeing supported and permitted
approximately 80% of the community optometry
We were pleased when we cases. The reputation of practices to deliver risk-
were able to offer routine optometrists as frontline stratified and needs-driven
eye examinations once healthcare workers has care throughout lockdowns.
again. While emergency and grown. Patients have a greater However, although HSCB
essential cases continue to be understanding that they can has reasonable confidence
prioritised, the importance of make an appointment with that the majority of need for
routine examinations cannot their community optometrist essential and urgent primary
be underestimated, and for their health, not just to eye care has been met, the
indeed in Scotland everyone purchase eyewear.’ challenge to manage demand
is entitled to an NHS-funded Sali Davis, CEO for ophthalmic services
examination. Practices across of Optometry continues. Community
the country are continuing to Wales optometrists are playing a
wear NHS-provided PPE and vital role in delivering new
are scrupulously following Northern Ireland models of integrated care,
infection control procedures.’ A
‘ lthough now back to near managing patients closer
Julie Mosgrove, Vice Chair of normal pre-COVID levels, to home.’
Optometry Scotland primary eyecare activity in Raymond Curran,
Northern Ireland was impacted Head of Ophthalmic
dramatically after lockdown. Services, Health and
Average General Ophthalmic Social Care Board, Northern
Services and Enhanced Service Ireland
claims prior to the pandemic
were c185K per quarter. For
Q1 (April-June) 2020/21 this
number fell to c19K.
The State of the UK’s Eye Health 2021 11Tackling a nationwide emergency
As COVID-19 restricted access
for patients our partnership
with Newmedica has helped
us proactively manage our
ophthalmology care, allowing
the hospital eye service to
focus on emergencies and
Supporting NHS During the course of the urgent and complex cases.
pandemic, more than 4,000 Simon Taylor, Associate
ophthalmology patients were transferred Director of Operations,
services to Newmedica eye health Surgery and Anaesthetics,
clinics and surgical centres West Suffolk Hospital
throughout throughout England by the
England NHS locally. While most of The last year has highlighted
these appointments were the difficulty in supporting
Newmedica is a leading for cataract surgery and the local acute system to
provider of NHS-funded follow-up, patients also deliver outpatient follow-ups
ophthalmology services in attended Newmedica clinics and some surgical capacity.
England. The Newmedica- for glaucoma and wet age- Flexibility by all partners
Specsavers partnership works related macular degeneration and the willingness to do all
closely with all optometrists treatment. The programme we can to treat patients as
and GPs through a national focused on patients waiting safely and quickly as possible
network of specialist eye the longest for treatment, was evidence of useful joint
clinics. The aim has always so people were seen in working.
been to transform care and order of need. Eddie McCabe, assistant
IMAGE: iSTOCK
treatment in the community Adam Wannell MCOptom, director of contracting and
for patients facing the Head of Clinical Optometry performance at North East
prospect of losing sight. at Newmedica Lincolnshire CCG
The State of the UK’s Eye Health 2021 12Putting families first
Nobody can deny that The reasons for this concerning to seek advice about vision
COVID-19 has wreaked havoc trend are multi-fold. Stuck at concerns has undoubtedly
on the nation’s health, but the home, alcohol consumption played a part in diminishing eye
ripple effect of the pandemic is increased[11], people smoked health too. Tellingly, community
now laying bare its devastating more cigarettes[12] and ate less optometrists reported a sharp
impact on unforeseen aspects healthily[13], all of which have downturn in the number of
of wellbeing, none more so a negative effect on optical people of all ages booking
than our eyesight. health. Exposure to natural eye tests. Ophthalmologists
Disturbing statistics from the daylight, essential for healthy also noted a rise in missed
College of Optometrists[10] eyes, plummeted as we spent appointments in the past 12
have revealed how almost more time indoors, often months[10,14] with Moorfields >
one third (31 per cent) of hunched over screens as we
UK adults claimed their worked, exercised and shopped
vision deteriorated during at home. But a reluctance
successive lockdowns and
Daniel Hardiman-McCartney,
clinical adviser at the College,
says that there’s evidence of
‘a marked increase in those
worried about their eyesight’.
IMAGE: iSTOCK
The State of the UK’s Eye Health 2021 13Putting families first
action to prevent an epidemic
of worsening eye health.
Action must also be self-
initiated, fuelled by a desire
they had underestimated the to protect our own eye
seriousness of eye health[10] health and that of our family
Eye Hospital, King’s College problems during a time when and friends. ‘Your lifestyle
London Hospital, University a life-threatening virus was can impact your eye health
Hospital Southampton afflicting so many. regardless of your genetic
and Whipps Cross Hospital predisposition,’ says David
reporting steep drops of up to Yet the resulting fall-out Cartwright, chair of the charity
87 per cent in attendance in could be far-reaching and Eye Health UK, the organisation
some groups during the first catastrophic. Parents have behind National Eye Health
months of the coronavirus expressed concern about Week. ‘What we eat and drink
outbreak[14]. a decline in visual function and how we exercise can all
impacting educational play a part in protecting our
The no-show for eye development of their young eyesight.’
appointments extended to children[15] and researchers
people with known age- warned in the British Journal Many eye diseases are linked to
related macular degeneration of Ophthalmology[16] that obesity and its related health
(AMD) – the nation’s biggest less time outdoors and more problems, such as diabetes.
cause of blindness – with time in front of a screen might Maintaining a healthy weight is
researchers from UCL Institute lead to an increase in myopia, important for eye health, as is
of Ophthalmology and the or short-sightedness, in eating a diet packed with eye-
Macular Society suggesting primary school-aged children. healthy antioxidant vitamins
there was a 25% reduction in Financially, too, the burden of C, E, zinc, selenium and copper,
the number of patients with vison problems on society is which the European Food
AMD attending appointments considerable. Things will only Safety Authority (EFSA) says
for sight-saving treatment get worse unless the downturn play a key role in the fight
IMAGE: iSTOCK
[14]. Understandably, many is redressed and this economic against the development of
cited concerns about evidence should provide a eye conditions, such as age-
catching COVID-19 or that springboard for government related macular degeneration >
The State of the UK’s Eye Health 2021 14Putting families first
(AMD). Lutein and zeaxanthin,
found in leafy green vegetables
are also important as they
have been shown to protect
macula cells from oxidative
stress. By taking responsibility
to eat well we are taking
important steps towards the
Sofia’s story
future health of our eyes.
Dr Paramdeep Bilkhu, clinical
Sofia, aged six,
advisor to the College of
Optometrists, says we should
experienced a change in
all remember to take regular
screen breaks. A ‘ useful her eyesight which left
her unable to see clearly,
reminder is the 20/20/20 rule,
where we advise you look
away in the distance (around
20 feet) every 20 minutes for
20 seconds, and blink regularly
with or without her
to keep the eyes comfortable,’
Bilkhu says. And regular eye
glasses
checks are vital in detecting
problems early enough that Her father James contacted her experience enjoyable.
they can be treated. ‘Vision the eye hospital. They During the whole process,
that is only slightly reduced were unable to confirm gloves, masks and visors were
can have a tangible influence an appointment for changed regularly and Sofia
on quality of life,’ David several months due to the was given PPE to wear, which
Cartwright adds. ‘It is so coronavirus crisis. James had she thought was great. She
important that you encourage some immediate concerns now has new glasses with
everyone in your family to around Sofia’s deteriorating her new prescription, which
have their eyes tested regularly vision so he contacted his was a significant change
and to seek help for any eye community optometrist in from the previous one. Most
problems sooner rather than Berwick. Sofia was given an importantly, she can see
later, especially as much sight immediate appointment. properly again.’
loss can be avoided if James says: ‘Sofia was
detected early.’ supported throughout her
Peta Bee, eye examination. She was
health and fitness made to laugh non-stop
journalist by the team, which made
The State of the UK’s Eye Health 2021 15Living well in later life
There are more than 12 million 272,000 There is mounting evidence
people in the UK aged 65 or that sight loss affects more
over. More than 1.5 million are 137,500 than how people see and
aged 85 or over[17]. has implications for physical,
In the UK it is estimated that cognitive, and mental
Evidence shows the risk of 272,000 people with sight health[20]. Older people, like
serious eye conditions and loss aged over 65 experience David below, are typically
sight loss increases with age. a fall each year and of these extremely resilient but as
nearly half are directly coronavirus made access to
attributable to problems support more difficult, those
75+ with vision. dealing with significant health
challenges have struggled
to cope[21].
Currently one in five 10,000+
people aged 75 or over is
living with sight loss[18].
Losing vision, or hearing, Poor vision is the direct cause
can have a major impact of more than 10,000 serious
on wellbeing and for older falls every year that result in
people the risk of falling, hospital admission[18].
with adverse outcomes,
increases significantly[19].
The State of the UK’s Eye Health 2021 16Living well in later life
‘Eye problems are increasingly common as we age, so
it’s more important than ever to look after our eye health
and have regular check-ups with a community optometrist
at this stage in our lives. We know waiting lists have
become horrifically long for routine surgery but that’s no
reason to ignore any changes in our sight. No one should
hang back from asking for help or an expert opinion about
an eye problem. If you are in urgent need you will be a top
priority for treatment. It’s always best to get a qualified
person to take a look and that will give you peace
of mind too.’
Caroline Abrahams, Charity Director at Age UK
David’s story
‘As an artist I value my sight and I
know I could have lost it’
‘I’m very proud that my fibres. This may lead to loss
design was chosen for of vision if left untreated.
a commemorative 2012 ‘With a family history of
Olympics 50p coin. It is now glaucoma, I’m particularly
sought after by collectors.’ careful,’ says Mr Gibbons.
says David Gibbons. ‘As an ‘There are treatment options
artist I value my sight and I for glaucoma and the earlier
know I could have lost it.’ it’s picked up the better.
Mr Gibbons had cataracts
removed from both eyes ‘Everyone’s sight is precious.
and takes drops each An eye test every two years
day to combat glaucoma. For many people glaucoma should be on everyone’s to-
He has his sight checked has no symptoms until a do list because it can, quite
throughout the year to painless rise in pressure literally, save your sight.’
ensure the glaucoma is inside the eye has caused
kept at bay. irreversible damage to nerve
The State of the UK’s Eye Health 2021 17Living well in later life
Sue Perkins shares Now she thinks we all need
to take our eye health more
her story and calls
seriously.
‘I think eye checks are
on everyone to have incredibly important. It’s not
just about changing your
regular eye tests prescription, it’s to look at
what’s going on behind the
eye to see if there are any
Broadcaster, presenter developing issues. These tests
and writer Sue Perkins is can give you a really good idea
renowned for bringing joy and of what’s going on with
laughter to the nation, as a your eye health and your
presenter on The Great British general health overall.’
Bake Off and most recently as
Dragon in The Masked Singer Sue knows most things that
and the new host of BBC optometrists see can be
Radio 4’s long running quiz treated if caught early enough.
show, Just a Minute.
eye health issues in her ‘During the pandemic I went
Wearing glasses and looking immediate family. from a life that was busy and
after her eye health are external to one conducted
integral to Sue’s life. Her ‘My father’s eyesight had almost entirely on Zoom. I have
memoir, published in 2015, been deteriorating so he a dry eye condition so itching
is called Spectacles and she went to his local Specsavers and irritation were much more
was acknowledged for her for some checks. I think the noticeable. This was easily
Services to Specs at the 2019 optometrist knew he was sorted with drops. You don’t
Spectacle Wearer of the very ill, but she took care not have to live with these things
Year Awards. to worry him as she referred if you have your eyes checked
him to a doctor. Sadly, we regularly.’
‘As a young child I had lots of discovered my dad had an
squint operations, then I had inoperable brain tumour. That Sue has welcomed the
an eye accident when I was is a source of huge personal 2021 State of the UK’s Eye
14. My optometrist told me pain for me and my family, Health report.
I needed glasses because I but we remain so grateful for
could barely see anything out the care we received from ‘There needs to be more
of my left eye. I put my new Specsavers and the doctors.’ health messaging around the
glasses on and now they are importance of eye tests. I
very much a part of who I am. Sue admits she did not hope the State of the UK’s Eye
understand the importance Health report can point people
Sue also has experience of of regular eye tests until then. in the right direction.’
The State of the UK’s Eye Health 2021 18Looking to the future
Community optometry is supporting a growing number of people with more complex needs.
People with dementia, learning disabilities and stroke survivors are all at increased risk of vision
problems that can cause permanent damage.
Stroke Dementia Learning disability
10x
60%
866,000
People with learning disability
are ten times more likely to
Around 60 per cent experience sight loss than
of stroke survivors the general population. In the
immediately experience 143,000 UK there are around 105,700
visual problems[22]. There people with learning disability
are national guidelines In the United Kingdom, and severe visual impairment
recommending specialist around 866,000 people are or blindness[25].
vision assessment for living with dementia[23].
this group. Research indicates around
143,000 people have 500,000+
dementia and significant
sight loss[24]. More than half a million
people with a learning
disability experience
refractive error, yet accessing
eye tests can be challenging.
Pam’s story
‘Thank goodness I made that call’
When Pam Humphries and spotted unusual medication. Pam says:
explained her sudden loss of swelling on optic discs that ‘Thank goodness I made
vision over the phone to her led him to suspect Pam that phone call during
optometrist, Manish Soni, he had experienced a stroke. lockdown. It does scare me
scheduled an appointment A specialist at Pam’s local to think if I hadn’t picked up
straightaway. Manish noted hospital confirmed this and the phone I might not be
changes in blood pressure prescribed blood thinning here today to tell my story.’
The State of the UK’s Eye Health 2021 19Collaborating to save sight
Our patients are driving Age-related Wet AMD can develop quickly.
changes in the way health Early detection and treatment
care is delivered. macular is vital to halt further
degeneration development. Dry AMD can
Ophthalmology is the develop slowly and there is
largest outpatient speciality AMD commonly affects currently no treatment.
with 7.8 million outpatient people over the age of 50
appointments annually[26].
Across the UK community
and it is the leading cause
of blindness in the UK. As it
2.95 million
optometry and hospital eye affects central vision reading In the UK there are an
services are collaborating becomes difficult. Colours estimated 2.95 million people
to meet patient need and become less vibrant and living with the early stages
save sight. people’s faces are difficult to of AMD
recognise[27].
640,000
and 640,000 in later stages
of the disease.
27%
Olwyn’s story The number of people
living with late stage AMD
‘I noticed changes in the UK will increase by
27% by 2030[28].
to my vision’
‘I made an appointment when I which simply couldn’t be seen
noticed changes to my vision,’ without the use of the scan,’
says Olwyn. Community says Suresh. Olwyn’s referral to includes regular
optometrist, Suresh Mahandru, the eye hospital came through reviews. Olwyn recently
was unable to detect any within a week and a diagnosis returned to her community
issues on the outermost of wet age-related macular optometrist for an eye test.
visible surface of the retina degeneration was confirmed. The results showed improved
initially, ‘When I examined the If left, this could have resulted vision. ‘I would strongly
images from the OCT, I could in a loss of vision. The encourage anyone who
see there were fluid filled hospital consultant made a notices a problem to make
spaces within the retina itself, treatment plan which an appointment,’ she says.
The State of the UK’s Eye Health 2021 20Collaborating to save sight
In Bedfordshire, enhanced community cataract pathways
have been developed for pre and post-operative
assessments. Pre-operatively this is key to reducing
avoidable outpatient appointments and enabling risk
stratification, thereby improving the patient experience.
We use shared decision making to ensure that patients are
willing to proceed with surgery before referral. All routine
post-operative checks are also carried out by community
optometrists, who check for complications and feed back
relevant information to the Hospital Eye Service.
Rachel Thomas, Lead Optometrist,
Moorfields at Bedford
Cataract
Cataract is a common eye
condition, prevalent in older
people. Over time cataracts
cause the lens to turn cloudy
420,000
making things look misty, and currently there are
especially on bright sunny 420,000 cataract surgeries
days[27]. per year[26].
85%
713,000 The majority of postoperative
cataract appointments can
26%
In the UK there are an take place in the community;
estimated 713,000 people the National Transformation
living with a cataract[28] By 2030 the number of Programme estimates
people living with a cataract 85%[26].
will grow by around 26%[28]
and the demand for cataract
operations will increase.
The State of the UK’s Eye Health 2021 21Collaborating to save sight
Glaucoma
Glaucoma is a group of eye diseases which damage the optic nerve due to changes in
pressure inside the eye (ocular hypertension). Symptoms often go unnoticed though as
peripheral vision is affected first. For example, a driver with glaucoma might not
see a pedestrian trying to cross the road at the periphery of their vision.
1.39 million 18% 50%
There are an estimated The number of people living Glaucoma referral filtering
1.39 million people living with glaucoma in the UK will schemes demonstrate that
with ocular hypertension increase by around 18% in the 50% of referrals are avoided
and a further next 10 years[28]. and the rate of false positives
falls from 40% to 10%[26].
708,000 The National Transformation
Programme recommends
living with glaucoma. Early
20% scaling up this approach
detection followed by careful to reduce new patient
observation and regular Twenty per cent of follow up referrals and introducing
treatment can usually appointments in hospital eye community diagnostic hubs
minimise loss of vision. services are for glaucoma. to deliver glaucoma follow-up
appointments.
Glaucoma care University Health Board. If any to patients. The service
deterioration is identified, the uses the capacity and
in Wales patient sees a consultant at skills of local community
Glaucoma patients in a hospital-based eye clinic. If optometrists to relieve the
Merthyr were the first not, the patient will continue burden on secondary care.
to trial a new primary to be regularly reviewed Hospitals can concentrate
care-based assessment locally. The technology being on seeing higher risk
service supported by used to share patients’ patients knowing lower risk
the Welsh Government’s information is a first in the UK patients are being seen on
Health and Social Services for eye care due to the way time in the community. This
Transformation Fund. Lower full scans and videos of the is the future of glaucoma
risk patients are assessed optic nerve, macula and visual care, and we will be at the
in a community optometry fields taken during assessment forefront of this service
practice and results are are available instantly for the model here in Wales.
shared in real time with hospital-based specialists to Andrew Feyi-Waboso,
ophthalmology consultants review. Shared glaucoma care Ophthalmic
at Cwm Taf Morgannwg brings excellent care closer Consultant
The State of the UK’s Eye Health 2021 22Collaborating to save sight
Diabetic eye disease
print[27]. Detection of early 20%
stage eye disease through
Over 1 in 20 people in the UK regular diabetic eye screening More than 20% of follow
has diabetes[17,29]. and eye tests, then swift up appointments in
referral for treatment, can hospital eye services are
1.33 million help prevent this. for medical retina. Most are
for macular degeneration
Around 1.33 million people or diabetic eye disease. The
have diabetic retinopathy[30] National Transformation
which can lead to severe 5% Programme estimates that
and permanent loss of sight. community optometry
People might experience In the next 10 years the could deliver up to half
flashes of light or wavy vision, number of people living with of these appointments in
trouble with bright lights diabetic retinopathy in the UK diagnostic or treatment
or difficulty in reading small will increase by around 5%[30]. hubs[26].
Sharing eye Data-sharing is a critical We support people to live
part of this plan. ‘Sharing well with glaucoma and we
health data learning encourages more fund sight-saving research.
Even before COVID-19, collaboration, which leads to We are passionate about
community optometry better decision-making and raising awareness and want
recognised the need to improved patient outcomes. to highlight the significant
do things differently. The At Specsavers we give our impact COVID-19 has had on
rise in emergency hospital optometrists clinical outcome glaucoma care. Specsavers
admissions, more complex reports as we believe that provided us with some of
health problems and an giving them greater access to their data so we were able
aging population meant data encourages continuous to comment on the 70%
something had to change. improvement to meet reduction in referrals from
NHS England National the needs of those who optometry to hospitals
Eyecare Planning and depend on us so much. compared to 2019. This
Implementation Guidance[31] Giles Edmonds, helped us draw attention
emphasises a co-ordinated Specsavers Clinical to the need for an action
approach to transform Services Director plan to dramatically improve
eye care, so patients are services as we emerge from
treated at the right time, in Glaucoma UK campaigns lockdown.
the right place, by the right to raise awareness so Karen Osborn,
professional. glaucoma is detected early CEO of Glaucoma
and can be treated. UK
The State of the UK’s Eye Health 2021 23Developing tomorrow’s
experts
Professional training for community optometrists is at the heart of the NHS
Eyecare Recovery and Transformation Programme[32] . Gill Robinson, Director
of Professional Training at Specsavers, has dedicated her career to professional
advancement of community optometry. On the eve of her retirement Gill shares
her view on the future of training and development.
During the pandemic we us to schedule sessions for safety procedures were at the
found new ways to structure different times of the day so heart of our training offer. All
training sessions to make learning can fit around busy our clinical teams have the
the most of online formats. clinic schedules and there is no opportunity to tap into the
Discussion with colleagues, need to spend time travelling expertise of ophthalmologists
which encourages the to conference venues. and specialist optometrists,
sharing of knowledge and Feedback from our many enabling them to apply this to
experience, is a feature of thousands of participants their decisions in community
the new-style sessions. Many suggests the majority wish to practices and give patients
are multidisciplinary with retain this flexible learning. access to the right advice and
optometrists, contact lens care at the right time.
opticians and dispensing As referrals into hospitals
opticians learning together in became a critical issue Gill says, ‘I’ve been privileged
a way. Online delivery allows to reduce the burden on to work alongside so many
the NHS, we ensured that innovators and experts at a
professional body guidance time of profound change. It
on referral protocols and has been exciting to make a
small contribution as digital
technology has opened up
more accessible and engaging
forms of learning. I am certain
the next 25 years will offer
many advances and new
opportunities for professional
development, through flexible,
individualised programmes
and collaborative learning
environments.
The State of the UK’s Eye Health 2021 24Digital Innovation
in Eye Care
Jason Higginbotham of FYEye Ltd is an independent
Optometrist and Dispensing Optician. He reflects on how
digital innovation has accelerated during the pandemic.
Sight-threatening conditions Artificial intelligence (AI), other eye conditions. AI is
are increasingly seen as remote testing, telemedicine improving and will become
a threat to humanity, and remote refraction widespread. Moorfield’s eye
recognised by the WHO[33] have evolved rapidly. A hospital is working with
and the United Nations[34]. significant innovation in eye Google Deep Mind to achieve
AMD, glaucoma and myopia care has been OCT (optical reliable diagnostic ability
are economic threats, as coherence tomography). from their OCT AI. AI for
well as human tragedies. As education catches up improved diabetic retinopathy
Innovation will reduce with the technology, OCT screening is already used
these threats. should improve the early extensively and will continue
detection of glaucoma and to develop.
The State of the UK’s Eye Health 2021 25Digital innovation in Eye Care
Digital
innovation
often promotes
sustainable practices.
The OSA (Optical
Suppliers Association)
looks closely at how the
manufacture of contact
lenses, frames, and spectacle
lenses can be more
environmentally friendly.
the optometrist. Remote Optometry can reduce the
refraction is already used in load on ophthalmology
Telemedicine has seen a some places. Robotic and out-patients. Shared care
surge in use, mainly where automated equipment will be schemes that
community optometrists send with us very soon. use data-linked resources
results to hospitals serving can reduce printing and
large areas. CUES (COVID-19 Software delivers benefits, patient travel and in turn
Urgent Eyecare Service) was including the potential to reduce our carbon footprint.
developed to send patient conduct multiple diagnostic
data to consultants - a tests on computers in the Innovation will make
form of telemedicine. Linked patient’s home. The potential significant changes for the
to this is the potential to for triaging or monitoring better and rapidly. Our
carry out most parts of an patients unable to visit their patients seem to have
eye examination without community optometrist embraced these solutions.
direct interaction with is vast. Clinicians must do the same.
change in glaucoma once cases are sent urgently to
A game- visual field loss has occurred. the right professional. It is
changing IT The new Glauc-Strat-Fast an excellent example of AI
solution for risk stratification tool[35]
draws on this approach and
assisting clinicians to make
better decisions, resulting in
glaucoma helps to reduce the burden improved patient outcomes.
patients on the NHS. Most importantly, Ultimately, other critical
however, it reduces avoidable conditions like AMD, Myopia,
Visual field assessment blindness from delays in diabetic eye disease and
remains the only viable way glaucoma care. The tool more could benefit from
of monitoring and detecting helps ensure that suitable similar systems.
The State of the UK’s Eye Health 2021 26A final word
In caring for eye health, so optometry profession has an
much has happened in the unprecedented opportunity
last 18 months – missed to make a positive difference
appointments, huge backlogs, by working together with
entire families spending the ten thousand highly
hours gazing at screens skilled opticians in the UK
through lockdowns… and to integrate fully with GPs
everyone knows about older and with ophthalmology to
family members too often reduce preventable sight loss
isolated in their own homes about ensuring that no one and its impact and so help
or care homes for long needlessly loses their sight. reduce the pressure on an
periods. There’s no doubt We are doing all we can in already over-burdened NHS.
that this has been a tough these very difficult times to
year for all of us. Our State reach the people most at risk A joined-up community-
of the UK’s Eye Health 2021 with crucial health messages. based approach to eye
report paints a stark picture That’s why we are playing care that embraces
of the challenging context a leading role in National advances in diagnostic and
we have been living and Eye Health Week to convey communications technology
working in. to millions of people that a offers our patients a
regular eye test can help save convenient, more accessible
Specsavers is so proud of your sight. service that will improve
the committed and talented efficiencies and clinical
people who have gone the But there is so much more outcomes all round.
extra mile to serve their still to do. There are even
communities during this time bigger challenges ahead as, Community optometry
of crisis. This has accelerated from the millions of people is ready to take on this
the shift towards patient- who missed appointments, challenge with energy,
centred pathways that greater numbers will present confidence and commitment,
deliver care nearer to home. in community optometry and with highly skilled and
Community eye care has ophthalmology with more technologically-enabled
shown great resilience and, serious and more advanced clinicians saving sight and
despite the challenges this vision problems that will have changing lives for the better.
pandemic has wrought, we a huge impact on our health Our patients inspire us to do
continue to provide frontline service and on the economy. even more. We are feeling
healthcare that for many can positive about the future –
be life-changing and sight- Changes we implement together.
saving. now will help secure the
long-term sustainability of Doug Perkins, Chairman and
Specsavers is passionate patient-centred care. The Founder of Specsavers
The State of the UK’s Eye Health 2021 27Method
Full methodology and system costs compared to have been an urgent referral
sources used to estimate 2013 was applied to each of from optometry may have
the prevalence of sight loss Northern Ireland, Scotland and been at risk of permanent sight
and blindness can be found Wales, with the assumption loss from their condition.
in ‘The economic impact of that changes to health system
coronavirus (COVID-19) on utilisation have been broadly For patients who either
sight loss and blindness in consistent across the UK. cancelled an appointment with
the UK[1].’ their ophthalmologist or had
Prevalence rates by age, sex
Quantifying their appointment cancelled,
it was assumed that there is
and eye condition were applied the impact of a level of risk of progressing
to 2018 population data, the coronavirus to sight loss due to delayed
latest available. Population treatment. Evidence from
projections were used to (COVID-19) literature was used to inform
estimate prevalence for 2019 The impact of lockdowns and the risk of progression given
to 2022[36]. decreased service utilisation in treatment compared to no
2020 will result in a decrease treatment for the period of the
Estimating cost in total cost for eye care
that year. There will be an
delay for anti-VEGF injections.
For glaucoma treatment, it was
components increased demand for services assumed that each patient is at
The research uses previously in subsequent years, primarily risk of progression immediately
estimated unit costs of sight driven by the backlog of as a result of the cancelled
loss and blindness in the procedures. This will attribute procedures.
UK[37,38], updated for inflation additional costs to the
and demographic changes. healthcare system. The cost of delayed eyecare
Costs related to the healthcare as patients wait for their
system were re-estimated Patients who miss treatment procedure is calculated by
using NHS data[39] to account or receive delayed treatment applying the additional days
for likely changes in utilisation may experience some impact with disease (additional wait
of anti-VEGF treatments and to their vision health. Data time), with the daily cost, to
cataract surgery. Activity from Specsavers UK database each cost category (healthcare
data and unit costs for on referrals (stratified by level system, productivity losses,
elective surgery, inpatient of urgency) from optometrists informal carer costs, loss of
hospitalisations, outpatient to hospital eye services was wellbeing, efficiency losses and
services and anti-VEGF used to estimate the number other costs).
treatments were available of patients who did not receive
for England. Due to data an eye test and the decrease in The change in costs attributed
limitations, the percentage referrals. It was assumed that to cataract during the
growth in England’s health cases which otherwise would pandemic is driven by the >
The State of the UK’s Eye Health 2021 28Method
change in wait time for costs due to increased risk of the UK informed some
surgery. NHS data[40] was falls and the decrease in quality assumptions used in the
used to estimate the number of life due to worse outcomes. modelling pathway for
of missed cataract surgeries A similar approach is applied the impact of coronavirus
from March to December 2020. to other hospital ophthalmic (COVID-19) on the healthcare
This was used to estimate procedures delayed due to the system and patient outcomes.
the additional number of pandemic. Freedom of Information (FOI)
people waiting for cataract data requests were submitted
surgery. The wait time pre- NHS Data on the change to several NHS trusts and
COVID-19 (before March 2020) in wait times for hospital health boards throughout
is compared to the average ophthalmic procedures[41] and the UK to gather information
wait time by December 2020. data on the changes in primary on the impact of coronavirus
The additional wait time in care optometry services were (COVID-19) and lockdowns
the December 2020 period obtained[42]. on their ophthalmological
was multiplied by the average services. FOI data was used
daily costs. The daily costs of Advice from ophthalmologists to support trends observed in
waiting for surgery include and optometrists throughout service activity.
Modelling pathway for the impact of coronavirus (COVID-19) on the
healthcare system and patient outcomes
Change in service
delivery
Inpatient hospitalisation
Day surgery
Outpatient service Reduction costs in 2020
Primary care optometry visit
Pharmaceutical
Impact on patient Change in cost of sight
outcomes loss in 2021 to 2024
Healthcare system costs
Additional wait time from Additional wait time from
surgical backlog surgical backlog
Productivity loss
Informal carer costs
Wellbeing costs
Delayed treatment Efficiency costs
Increased risk of sight loss
Fewer eye examinations Other financial costs
The State of the UK’s Eye Health 2021 29Method
Data on certification of vision impairment and registration were provided by local vision
charities. Galloway’s reported certifications supported by their Eye Clinic Liaison Officer in one
large teaching hospital decreased from 175 in the period 1 April 2019 to 31 March 2020 to 88 in
April 2020 to 31 March 2021.
New registrations following certification of vision impairment
Vision Charity Council New registrations 2019 / 2020 2020 / 2021
Dundee City 84
Ness
51
99
Aberdeen City
57
40
Moray
37
59
VisionPK Perth & Kinross
42
111
Wilberforce Trust City of York
72
420
Sight for Surrey Surrey County
310
15
Vista Rutland County
5
132
Leicester City
77
277
Leicestershire
188
64
Bury Blind Bury
39
Warwickshire Vision 205
Warwickshire County
Support 178
25
Vision Support Hartlepool Borough
17
Vision and Hearing 74
Gateshead
Support 54
seescape 67
South Tyneside
52
Sight Action 163
Fife
140
Highland 89
Sight Action
73
14
Western Isles
8
1938
TOTALS
1400
The State of the UK’s Eye Health 2021 30Life-changing Andy Britton,
store director at Specsavers
Haverfordwest, volunteered
community at a vaccination centre.
optometry
Specsavers has been
committed to eye health
ever since Doug and Dame
Mary Perkins set up their
first community practice in
1967. Now the whole family is
involved. Little did we know
how important these family
values and shared foundation
would be as we provided
services to patients and kept
our staff safe during the
pandemic.
Specsavers in Runcorn
In community optometry raised £3,000 for a local food
we see first hand how charity, helping to provide
distressing sight problems Christmas dinner Grant Welsh,
can be and how easily people for 800 people. store director at Specsavers
can become isolated. That’s in Bondgate, made almost
why our teams made heroic 3,000 glasses for key workers
efforts to reach out to so during lockdown two.
many patients. We are proud
that by caring for people in
our communities we made it
easier for NHS key workers
to concentrate on caring for
patients in hospital. Jamie Pullen,
director at Specsavers in
Barry, repairing broken
glasses outside the home of
14-year-old Bex, who was
shielding with her family.
The State of the UK’s Eye Health 2021 31Life-changing community optometry
Nurse Sarah Banks, Lynn Johnson,
was burgled. Specsavers and manager at Specsavers
the local community rallied to Saltcoats came to the rescue
replace stolen items, including of local church minister,
stolen spectacles. Reverend Don Currie, who
had broken his glasses on
the morning he was due to
officiate a wedding.
Hospital staff
receive hampers from
members of Castle Hume
Golf Club, supported by
Specsavers team Specsavers Enniskillen.
in Edinburgh make a 4-hour
round trip to the Highlands
to replace glasses lost during
a paddle boarding staycation.
Cat Woman visits
her community optometrist
because even superheroes
need their eyes tested!
Specsavers is supporting Kent
Association for the Blind to
Coleraine hospital share eye health messages.
worker, Julie, broke her
glasses mid-pandemic. Her
local Specsavers community
practice sorted out new
glasses within 45 minutes,
free of charge as a thank you
to local key workers.
Katy Andrews,
Riz Choonara, director at Specsavers Marlborough,
director at Specsavers Stroud, hand delivered contact lenses to a
cycles to deliver eye drops soldier about to be deployed to
to an isolating patient. help enforce the first lockdown.
The State of the UK’s Eye Health 2021 32References
[1] Deloitte Access Economics. (2021). The Factors Among Schoolchildren in Japan. JAMA Public Health Action Support Team, published
economic impact of coronavirus (COVID-19) on Ophthalmol. 2019 Nov 1;137(11):1233-1239. by Local Optical Committee Support Unit.
sight loss and blindness in the UK. doi: 10.1001/jamaophthalmol.2019.3103. PMID: Prevalences applied to subnational population
[2] Estimated from Specsavers data. 31415060; PMCID: PMC6696729 projections.
[3] NHS Digital, ‘Hospital Episode Statistics’ [16] Zhang X., Cheung S.S.L., Chan H., et al. [29] Diabetes UK. Diabetes Prevalence 2019.
Hospital Episode Statistics (HES) - NHS Digital Myopia incidence and lifestyle changes among https://www.diabetes.org.uk/professionals/
[4] Wickham, L., Hay, G., Hamilton, R. et al. school children during the COVID-19 pandemic: position-statements-reports/statistics/
The impact of COVID policies on acute a population-based prospective study. British diabetes-prevalence-2019
ophthalmology services—experiences from Journal of Ophthalmology (2021). https://doi. [30] R. Mathur et al (2015), Diabetic eye disease:
Moorfields Eye Hospital NHS Foundation Trust. org/10.1136/bjophthalmol-2021-319307 A UK Incidence and Prevalence Study, London
Eye 34, 1189–1192 (2020). https://doi.org/10.1038/ [17] Office for National Statistics (2020) School of Hygiene and Tropical Medicine. RNIB.
s41433-020-0957-2 Population estimates for the UK, England and Prevalences applied to subnational population
[5] Ting DSJ, Krause S, Said DG, Dua HS. Wales, Scotland and Northern Ireland: mid projections.
Psychosocial impact of COVID-19 pandemic 2020. [31] RCOphth. Eye Care Planning
lockdown on people living with eye diseases [18] RNIB Sight Loss Data. Published 2021, Implementation Guidance 2021-22 Summary
in the UK. Eye (London, England). 2021 version 4.3. Accessed via https://www.rnib.org. (Annexe). https://www.rcophth.ac.uk/wp-
Jul;35(7):2064-2066. DOI: 10.1038/s41433-020- uk/datatool on 29 July 2021 content/uploads/2021/06/Eye-Care-Planning-
01130-4. [19] Boyce T., Stone M.K., Johnson S. and Simkiss Implementation-Guidance-2021-22-Summary-
[6] FOI data request provided by NHS Greater P. (2013), Projecting numbers of falls related to Annexe.pdf
Glasgow and Clyde, Belfast Health and Social visual impairment. British Journal of Healthcare [32] RCOphth. The National Eye care recovery
Care Trust, Cardiff and Vale University Health Management Vol 19 No 6. ; Scuffham, P. et al, and transformation programme (NECRT):
Board, NHS Lothian, Moorfields Eye Hospital (2003), Incidence and costs of unintentional A message from President Bernie Chang.
NHS Foundation Trust, Swansea Bay University falls in older people in the United Kingdom, https://www.rcophth.ac.uk/2021/06/necrt-
Health Board. Journal of Epidemiology and Community programme-president-message/
[7] Jackson J., Silvestri G., Stevenson M., Sinton Health, Vol. 57, No.9, Sept. 2003, pp.740-744. [33] World Health Organization. Regional Office
J., Witherow J., McCann R., Moutray T., & Cushley Prevalences applied to subnational population for South-East Asia. (2009). VISION 2020.
L. COVID-19: The regional impact of COVID-19 projections. WHO Regional Office for South-East Asia.
on the certification of vision impairment in [20] Swenor B.K., Ehrlich J.R. Ageing and vision https://apps.who.int/iris/handle/10665/206523
Northern Ireland. Ophthalmic Physiol Opt. 2021; loss: looking to the future. Lancet Glob Health [34] United Nations. A/75/L.108. General
41: 136–143. https://doi.org/10.1111/opo. 12757 2021; published online February 16, 2021. https:// Assembly. 6 July 2021. Seventy-fifth session.
[8] RCOphth (2021) Sight impairment and doi.org/10.1016/ S2214-109X(21)00031-0. Agenda item 24 Eradication of poverty and
severe sight impairment certifications and [21] Age UK (2021). Impact of Covid-19 on older other development issue. Vision for Everyone:
registrations update. https://www.rcophth. people’s mental and physical health: one year accelerating action to achieve the Sustainable
ac.uk/2021/03/sight-impairment-and- on. Age UK. Development Goals. https://www.undocs.org/
severe-sight-impairment-certifications-and- [22] Rowe F.(2013). Care provision and unmet en/A/75/L.108
registrations-update/ need for post stroke visual impairment. [35] RCOphth. Ophthalmic Service Guidance.
[9] Akram, H., Dowlut, M.S., Karia, N. et al. Final report. Stroke Association and Thomas Joint RCOphth and UKEGS Glaucoma Risk
Emergency retinal detachment surgery during Pocklington Trust. Stratification Tool. July 2020. https://www.
Covid-19 pandemic: a national survey and [23] POPPI (2013), Projecting Older People rcophth.ac.uk/wp-content/uploads/2020/08/
local review. Eye (2020). https://doi.org/10.1038/ Population Information System. Institute of Glaucoma-Risk-Stratification-Tool-1.pdf
s41433-020-01187-1 Public Care for the Department of Health. [36] Office for National Statistics
[10] College of Optometrists. https://www. Prevalences applied to subnational population ‘National population projections:
college-optometrists.org/the-college/media- projections. 2018-based’ https://www.ons.gov.uk/
hub/news-listing/coronavision-concerns.html [24] Thomas Pocklington Trust (2007), peoplepopulationandcommunity/
[11] Kings College London. https://www.kcl. Dementia and serious sight loss, Occasional populationandmigration/populationproj
ac.uk/news/nearly-a-third-of-uk-public- paper February 2007, number 11. Prevalences [37] Deloitte Access Economics, The economic
drinking-more-alcohol-than-usual-during-the- applied to subnational population projections. impact of sight loss and blindness in the UK
pandemic [25] Emerson and Hatton (2004), Estimating adult population 2013 (report commissioned
[12] Future Health (2021) Make Smoking History. the Current Need/Demand for Supports for by Royal National Institute of Blind People,
https://www.futurehealth-research.com/site/ People with Learning Disabilities in England. December 2014).
wp-content/uploads/2021/05/Make-Smoking- Lancaster: Institute for Health Research, [38] Pezzullo L., Streatfeild J., Simkiss P., Shickle
History-170521.pdf Lancaster University, 2004 ; Emerson and D. The economic impact of sight loss and
[13] Baraniuk C. Fears grow of nutritional Robertson (2011), The Estimated Prevalence of blindness in the UK adult population. BMC
crisis in lockdown UK BMJ 2020; 370 :m3193 Visual Impairment among People with Learning Health Serv Res 2018; 18: 63
doi:10.1136/bmj.m3193 Disabilities in the UK. RNIB. Prevalences applied [39] National Health Service ‘National Cost
[14] Thomas D.S., Warwick A.N., Olvera-Barrios to subnational population projections. Collection for the NHS’ NHS England » National
A. et al. Estimating excess visual loss in [26] Roberts, C. and Stacey, C. 2020. Cost Collection for the NHS
people with neovascular age-related macular Transforming NHS Outpatient Care. LOCSU [40] NHS Digital, ‘Hospital Episode Statistics’
degeneration during the COVID-19 pandemic National Optical Conference, 25 November. Hospital Episode Statistics (HES) - NHS Digital
(pre-print). medRxiv 2020.06.02.20120642. https://www.locsu.co.uk/wp-content/ [41] NHS, ‘Consultant-led Referral to Treatment
https://doi.org/10.1101/2020.06.02.20120642 uploads/2020/11/NHSEI-NOC-2020-25112020. Waiting Times’ . Statistics » Consultant-led
[15] Yotsukura E, Torii H, Inokuchi M, Tokumura pdf Referral to Treatment Waiting Times (england.
M, Uchino M, Nakamura K, Hyodo M, Mori K, [27] RNIB and Specsavers. The State of the nhs.uk)
Jiang X, Ikeda SI, Kondo S, Negishi K, Kurihara T, Nation Eye Health 2016. RNIB. [42] Specsavers, ‘Specsavers Hindsight Report’
Tsubota K. Current Prevalence of Myopia and [28] NEHEM (2013) National Eye Health Eye and hearing care trends during COVID-19 |
Association of Myopia With Environmental Epidemiological Model. Data and models by Specsavers UK
The State of the UK’s Eye Health 2021 33You can also read
