December 3, 2024
It’s time to end avoidable sight loss in Wales

This National Eye Health Week, RNIB Cymru calls for urgent action to improve the nation’s eye care.

The beginning of Autumn usually means a few things: pumpkin spice in everything, Autumn rugby internationals, bringing out the chunky knits and for us at RNIB Cymru, National Eye Health Week (23-29 of September). This is an annual awareness week where we promote the importance of keeping our eyes healthy and inform people of the small but vital steps they can take to protect their vision.

Half of all sight loss is avoidable with early detection and timely treatment. A sight test can detect early signs of sight-threatening conditions which can be treated if found soon enough. They can even detect other serious health conditions like diabetes and certain autoimmune conditions before other symptoms appear.

But this National Eye Health Week we are choosing to focus on an even more important issue. Over 80,000 eye care patients at the highest risk of irreversible sight loss are waiting too long for their appointments – a number which has more than doubled in the past five years. Sadly, for many who do lose some or all of their sight, this could have been avoided if they were seen on time. The amount of people with treatable eye conditions who are now at risk of permanently losing their sight would more than fill the Principality Stadium to capacity. So, as we head towards the Autumn rugby season, picture a stadium of cheering fans, and remember that the same amount of people are sitting at home, anxiously awaiting their fate, hoping for an eye clinic appointment that could save their sight.

Over 80,000 eye care patients at the highest risk of irreversible sight loss are waiting too long for their appointments – a number which has more than doubled in the past five years.

But why are people whose sight could be saved languishing on waiting lists while their vision deteriorates? Well, the reasons are complicated but as with most problems in our overstretched NHS, the efficient and timely delivery of eye care services is dependent on getting the right resources, people and infrastructure in place.

The problems facing Wales’ eye care services are longstanding and systemic. In 2022, Audit Wales highlighted eye care as one of the specialties that would struggle to recover because it was already severely stretched pre-pandemic. In the same year, the Royal College of Ophthalmologists found that half of NHS eye units in Wales did not have enough consultants to meet current patient needs. “Crumbling” estates, lack of clinical spaces and poor digital systems have all been identified as significant issues for Wales’ eye care services.

Eye care is already the single busiest outpatient specialty in the Welsh NHS, accounting for 1 in every 8 patients on the waiting list. But as we look to the future, this situation shows no sign of slowing. The prevalence of eye diseases like glaucoma and age-related macular degeneration increases as our population grows older. One in five people aged 75 and over in Wales is living with sight loss and demand for eye care services is expected to rise by as much as 40 per cent over the next 20 years.

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So far, Welsh Government has taken steps to alleviate pressure on hospital-based eye care services and address this worsening situation. This year, a new national optometry contract has been introduced which expands the role of high street optometrists enabling them to diagnose, treat, and monitor a wider range of eye conditions than ever before so that fewer patients need to be seen in hospital – a UK first.

But this is only a part of the solution. Hospital eye care services are still under immense pressure and patients with the most severe, sight-threatening eye conditions will still need to be treated in hospital. The Welsh Government asked the eye care clinical sector to develop “bold and ambitious plans” for how to tackle the backlog. Their key recommendations include developing regional centres of excellence to attract and retain qualified staff and pool ophthalmic capacity, expertise, and technologies. The Royal College of Ophthalmologists in Wales described the regionalisation of services as ‘vital for survival of ophthalmic care in Wales’.

We need enough healthcare professionals to deliver these services, with the right equipment and enough resource to be able to make this happen as quickly as possible.

Those plans are now on the desk of the new Cabinet Secretary for Health and Social Services, Jeremy Miles MS. But he will need to act quickly. While we wait and hope for a commitment and investment from the Welsh Government to support these plans to improve our eye care services, thousands of people are being added to the waiting list. We need enough healthcare professionals to deliver these services, with the right equipment and enough resource to be able to make this happen as quickly as possible. 

While the numbers are overwhelming and shocking, it is often those personal stories that have the most impact and can really help us to understand why investing in our eye care services in Wales is so vital. We hear from grandparents who’ve lost so much sight while they’ve been on a waiting list that they never saw the faces of their newborn grandchildren or watched them take their first steps. People waiting for treatment have lost their jobs, which depended on them being able to drive, which they could no longer safely do. What makes this truly heartbreaking is the knowledge that things could have been so different if only they had received the right care and treatment at the right time.  Because losing your sight won’t end your life, but it will change it forever.

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The time for action is now. We understand the scale of the challenge and clinicians have developed a plan for overcoming it. The former President of the Royal College of Ophthalmologists in Wales has warned of a “tidal wave of blindness” the consequences of which would be “catastrophic” unless urgent improvements are made to specialist eye care delivery. 

This is why RNIB Cymru is not only calling on Welsh Government to listen to healthcare professionals and commit to real change in our eye care services. We’re also asking them to listen to the personal stories of people affected by this crisis. If you would like to share your story or access advice and support during your eye care journey please get in touch by emailing RNIB Cymru on [email protected] or by calling our helpline on 0303 123 9999.

All articles published on the welsh agenda are subject to IWA’s disclaimer. If you want to support our work tackling Wales’ key challenges, consider becoming a member.

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