More cash for eye care should be the Government vision for the future
Mark O’donnell says pressure on health budgets could be cut by making sight loss a national clinical priority
iving with vision impairment impacts on every area of life, from education and work to transport and care services. Today there are around 170,000 people living in Scotland with significant sight loss with this number predicted to rise to more than 200,000 by 2030.
That is why Royal Blind believes it is time to make sight loss a national clinical priority. Action on preventable sight loss and better support for people living with vision impairment will not only improve the lives of hundreds of thousands of people, but is vital if scarce health budgets are to meet rising demand
As with many other health conditions, our ageing population is a major factor in this increase. Around three-quarters of people in Scotland with sight loss are over 65. However, an ageing population doesn’t tell the whole story – the Scottish Government Pupil Census for 2018 shows there were 4,574 pupils with vision impairment, more than double the number recorded in 2010, when there were 2,005 blind and partially sighted pupils.
We need to understand more fully the extent and reasons behind this increase, but better survival rates for premature babies and improved diagnosis of conditions like cerebral vision impairment are important factors.
This rising need presents challenges, but giving sight loss the priority it should have in our NHS will actually reduce demands on resources. Ensuring better access to rehabilitation services means more people with vision impairment can manage their condition better, remaining active in their communities and securing or remaining in employment. It will also mean fewer people living with preventable sight loss.
As the Scottish Government prepares to launch Public Health Scotland, we are making the case for a greater priority being given to sight loss in public health planning and campaigns. While the risk factors of smoking and diet are well understood for conditions such as heart disease and cancer, this is not the case for sight loss. There needs to be better public awareness of links such as those between smoking and macular degeneration, diet and diabetic retinopathy.
Crucially, a projected doubling of sight loss in the next few decades will only exacerbate inequalities and lead to an increase in mental health problems, unless preventative work is prioritised now. Speedier treatment for conditions such as cataracts and glaucoma can also help tackle preventable sight loss. However, too many patients with eye conditions are not receiving treatment within the 12-week target set out in the waiting time guarantee.
A freedom of information request submitted by Royal Blind revealed that six health boards breached the target in the quarter ending 31 March this year. Earlier this year the Royal College of Ophthalmology produced its workforce census which showed there had been a decrease in the number of consultant ophthalmologists in Scotland even at a time of rising demand, so it can be no surprise that a number of health boards are struggling to meet treatment targets. We recognise that the Scottish Government is targeting this in some areas, but demand for ophthalmology – already one of the busiest outpatient departments – is only going to grow.
We also need to do more to ensure that Scotland can be a leader in research in new treatments for eye conditions. Our country is a world leader in life science and medical research, but sight loss lags behind other conditions in terms of research funding. Scottish Government investment in research into cancer was more than £11 million between 2014 and 2018. While we understand the need for this important work, over the same period only £232,000 of these research funds were allocated to sight loss. It is difficult to understand why this gap in investment should be so stark.
Of course, we should not ignore the successes we have had in Scotland, whether that be the provision of free eye tests or action on waiting times. We are also very encouraged that the Scottish Government is positively considering proposals for a new
national community low vision service. But the case for going further is clear – making sight loss a national clinical priority is an investment for our future.
It means fewer people living with preventable sight loss, improving their quality of life as well as reducing pressure on health budgets. It means improved support for people with vision impairment so they can live independently and have better life chances. Making sight loss a national clinical priority now will benefit everyone affected by sight loss in Scotland in the years to come.
Mark O’donnell, chief executive, Royal Blind and Scottish War Blinded.