Ophthalmic health - power to the people
Demand for ophthalmology treatment is at an all-time high due our ageing population and a corresponding need for treatment of chronic eye diseases, such as macular degeneration, glaucoma and diabetic eye disease.
Professor Carrie MacEwen, the President of The Royal College of Ophthalmologists that some 10 million outpatient ap14 were for eye care and th increased pressure on ophthalmic services can no longer be ignored.dvancements in ophthalmic treatments mean that conditions such as age related macular degeneration, can now be treated successfully, but this adds to the demand on eye clinics.
The particular concern that Professor MacEwen raises is delays in follow up appointments at NHS eye clinics. The targets imposed on clinics which lead to fines if not complied with apply only to new patient referrals. The targets do not apply to follow up appointments and according to Professor MacEwen those with chronic eye diseases ‘are the most vulnerable and at the greatest risk of irreversible loss of vision’ and ‘require long-term ‘return’ or ‘follow-up’ appointments for repeat monitoring and regular treatment procedures.’
Investigations by the National Reporting and Learning System have identified a worrying number of incidents where patients, as a result of delays in obtaining follow up appointments, have suffered a loss of or deterioration in their sight.
The Royal College of Ophthalmologists is carrying out its own national study of this issue but states that it remains unresolved despite having been repeatedly raised, including by other bodies such as the Care Quality Commission.
As regards solutions, Professor MacEwen suggests the introduction of safety mechanisms to identify patients who require review and the collecting and using of data for follow-up appointments, postponements, cancellations and hospital initiated deferrals. She also suggests ‘protocols and guidelines to optimise efficient care; utilising the expanded skills and roles of ophthalmic nurses, optometrists and orthoptists; increasing networks between primary and secondary care and educating and empowering patients.’
All of these points need addressing but the last of these – educating and empowering patients - seems of particularly importance. Current patients must be made aware of the risks related to their eye conditions and the need for them to have continued ophthalmic input. This discussion perhaps also highlights the importance of more general education regarding eye health in the population as a whole, given the potential devastating outcome from eye diseases.