Expert calls for urgent publication of blueprint on eye care services

Publication of a blueprint to overhaul the delivery of eye care services is almost a year behind schedule at a time when ophthalmology inpatient/day case waiting lists have outstripped all other specialties leading to avoidable sight loss in some patients.

David Keegan: Government must act immediately

David Keegan, a consultant ophthalmic surgeon at the Mater Hospital, said more than half (54%) of patients with age-related macular degeneration (AMD) who are not treated in a timely manner suffer “significant vision loss”. The figure drops to 10% where treatment is timely, he said.

Patients with AMD require, on average, seven eye injections per annum, but it must be administered within 4-6 weeks of diagnosis to halt progression of the disease.

Figures from the National Treatment Purchase Fund (NTPF) show 10,138 inpatient/day cases are waiting more than three months for ophthalmology treatments.

How many of these suffer from AMD is unclear as the condition is bundled under general ophthalmology. The overall list is 13,115, the longest of any specialty in the country. An additional 33,818 people are awaiting outpatient appointments.

Age-related macular degeneration (AMD) (gradual sight loss due to blurring of central vision) is the leading cause of sight loss in people over the age of 50, with 7,000 new cases annually. The annual increase in AMD alone equates to a national need for between 45,000-50,000 eye injections per annum.

Mr Keegan said the blueprint for restructuring the delivery of eye care — the Primary Care Eye Services Report — was the “springboard” to a national plan that would allow more streamlined delivery of services, with less serious eye conditions treated in the community, freeing up space in the acute hospitals for more complex complaints.

“We have a hidden scandal on our hands but we also have a solution, if the Government acts now,” Mr Keegan said.

He said current service delivery was “all over the place” with the exception of diabetic retinopathy which is dealt with under the National Diabetic Retinopathy Screening Programme.

The call for implementation of the plan comes at a time of spiralling demand on services.

“Ten years ago, 1200 new cases a year would generate around 3,000 outpatient appointments. The same number of cases now would generate 30,000-35,000 appointments because we have treatments now that they didn’t have then to prevent blindness,” Mr Keegan said.

The National Council for the Blind of Ireland (NCBI), of which Mr Keegan is a board member, is also calling on the government to expedite publication of the report and implement its recommendations.

Chris White, NCBI CEO said the waiting lists were “even more shocking when you consider that as much as 75% of sight loss is avoidable”.

“NCBI is calling on the Minister for Health, Simon Harris, to urgently push for the publication and implementation of the Primary Eye Care Services Report, which was expected in summer 2015.”

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