Qualified local optometrists can manage certain eye care conditions rather than those based at hospitals, significantly reducing patient waiting times and lowering costs for the NHS, a new study finds.
The study, conducted by Cardiff University and funded by Health and Care Research Wales, focused on neovascular age-related macular degeneration (nAMD) and glaucoma – which are the most common causes of sight loss in England and Wales and require lifelong monitoring.
Consultant ophthalmologists usually treat these conditions as part of Hospital Eye Services (HES), with demand for these services to increase as cases of nAMD and glaucoma are expected to rise by 59% and 22%, respectively over the next decade.
Glaucoma and nAMD, however, can be treated by optometrists if they hold the relevant qualifications.
This study evaluated three areas of Wales where these enhanced services are provided by optometrists. The findings showed that in just one year, this reduced the number of people on the nAMD waiting list from over 216 down to three, and from 5,691 to five people for people with glaucoma.
Professor Barbara Ryan, who is the director of our new funded centre, Centre for Vision Services Research, led the study 'Hospital to Community: identifying the value of optometrists monitoring and managing chronic sight threatening eye disease in primary care' at Cardiff University.
Professor Ryan said: "We found using primary care enhanced optometry services will not cost any more than current care, and if appropriately-qualified optometrists are able to make decisions, it will free up the time of ophthalmologists and save costs."
We also found patients are as satisfied with the primary care services as they are with a hospital-based service and find it more convenient, especially in rural areas where optometry practices are often closer than hospitals.
"Importantly, for patients themselves, a timely appointment for suspected nAMD and for monitoring glaucoma may reduce their concerns as well as providing more swift reassurance about their eye condition or its management.
"The results suggest that over time it could reduce waiting times, clear backlogs and importantly, with patients seen promptly, reduce the risk of people losing sight because of delays."
The research team added that success would depend on good communication between professionals, clear pathways, adequate resourcing and strong coordination.
Following the study's conclusion in September 2023, new legislation formalised the use of enhanced optometric services in primary care in all areas.
