[unable to retrieve full-text content]
Hundreds of patients have suffered life-changing and irreversible sight loss because of a huge backlog in NHS care, a damning investigation reveals.
Clinicians have filed 551 reports regarding patient sight loss due to delayed appointments since 2019, with 219 resulting in ‘moderate’ or ‘severe’ harm.
The Association of Optometrists described the figures as ‘incomprehensible’ and ‘absolutely tragic’ and warned that hundreds more cases are likely to be unreported.
It is calling on ministers to commit to a national eye health strategy and to move up to half of appointments from hospitals to High Street clinics, so people can be treated faster.
Latest figures reveal 628,502 people are waiting for ophthalmology appointments – the second largest NHS backlog and equal to one in every 11 patients on an NHS waiting list.
Clinicians have filed 551 reports regarding patient sight loss due to delayed appointments since 2019, with 219 resulting in ‘moderate’ or ‘severe’ harm. The Association of Optometrists described the figures as ‘incomprehensible’ and ‘absolutely tragic’ and warned that hundreds more cases are likely to be unreported
Furthermore, 27,260 of those have been waiting a year or more, against a target of 18 weeks.
Patients report feeling ‘abandoned’ by the NHS and many are terrified of going blind because of the hold-ups. Some are forced into debt to go private.
In a survey of 876 UK optometrists, 72 per cent said they have seen a patient in the last six months who had experienced a delay to treatment of a year or more.
And 43 per cent expressed serious concerns over the number of patients they are seeing who could lose sight unnecessarily as a result long NHS waiting lists and cancelled appointments.
Optometry Today, the journal of the Association of Optometrists, obtained the figures from NHS England under Freedom of Information laws.
Read more: So much for tackling the backlog! NHS waiting list shoots to ANOTHER record high with 7.21m waiting for routine ops – while cancer delays spiral to worst-ever level
They show there have been 551 reports to the National Reporting and Incident system in relation to sight loss due to delayed appointments since 2019.
Of those reports, 99 incidents involved ‘severe harm’ and 120 incidents caused ‘moderate harm’.
One report describes a patient with wet age-related macular degeneration (AMD) who lost vision in their left eye after their injection treatment was delayed.
The patient was meant to have monthly injections but presented at clinic after three months had passed without an appointment.
Another patient reported their four-month follow-up appointment had been cancelled several times.
When they presented one year and four months later, a total retinal detachment was diagnosed.
Adam Sampson, chief executive of the AoP, said: ‘We are facing a health emergency.
‘Hospitals are overrun, and the NHS is collapsing under patient need.
‘There are good treatments available for common age-related eye conditions like macular degeneration but many hospital trusts simply do not have the capacity to deliver services.
‘Optometry is ideally placed to take away some of that burden – optometrists are already qualified to provide many of the extended services needed and are available on every high street, so patients can be treated closer to home.
‘It’s incomprehensible and absolutely tragic that patients are waiting, losing their vision, in many parts of the country because of the way eye healthcare is commissioned.
‘With a national strategy for eye care we can take a critical stride towards improving care and outcomes for patients.’
The findings come amid widespread NHS backlogs. Latest figures reveal 628,502 people are waiting for ophthalmology appointments – the second largest NHS backlog and equal to one in every 11 patients on an NHS waiting list. Pictured above, Prime Minister Rishi Sunak and Health Secretary Steve Barclay meet staff at St George’s hospital, London, last week
A separate poll by the AoP of 498 members of the public with macular eye conditions who have required medical treatment in the past two years reveal 57 per cent have experienced a delay whilst waiting for an NHS appointment and/or treatment.
Nearly half (47 per cent) have experienced a loss or decline in vision during this time.
Some 41 per cent of patients report being frightened of losing their vision entirely and 30 per cent feel abandoned by the NHS or authorities.
One respondent said: ’My vision deteriorated to such an extent that I went around armed with three different magnifying glasses.
WHY IS DRY MACULAR DEGENERATION?
Dry macular degeneration is a common eye disorder among people over 65.
It causes blurred or reduced central vision due to thinning of the macula, which is the part of the retina responsible for people’s direct line of sight.
More than 1.75 million people suffer in the US. The condition’s UK prevalence is unclear.
The wet form of the disorder occurs due to leaking blood vessels under the retina and causes more sudden vision loss than the dry form.
Dry macular degeneration develops gradually, affecting people’s ability to do things, such as read, drive and recognise faces.
Symptoms are usually painless and include:
- Visual distortions, such as straight lines appearing bent
- Reduced central vision
- Need for brighter lights
- Difficulty adapting to low-level lights
- Blurred printed words
- Reduced colour brightness
- Difficulty recognising faces
Dry macular degeneration usually affects both eyes eventually.
It rarely causes blindness due to peripheral vision being unaffected.
The cause is unclear and may be a combination of genetic and environmental factors, such as smoking.
It can be prevented via routine eye exams, managing conditions such as high blood pressure, not smoking and eating well.
There is no cure.
Treatment may include meeting with a low-vision rehabilitation specialist or surgery to implant telescopic lenses.
Source: Mayo Clinic
‘I really worried that the achievements of the previous years in maintaining my sight would be lost permanently.’
Another said: ’I’ve had no communication from the NHS, since my optician found the hole, and referred me four months ago. The success window is 6 months.
‘I’m now faced with paying £7,500 privately, which means going into debt.’
And a third added: ‘I am so worried that I have to constantly phone to get an appointment i.e. a cancellation, as no appointments have been sent out for over two years.
‘It’s so scary when you know that getting rapid treatment is essential to prevent scarring and permanent sight loss, yet when you ring for an appointment, you’re told the next available date is months in the future.
‘You feel totally helpless.’
Every day, around 300 people are diagnosed with macular disease – the biggest cause of sight loss in the UK.
Cathy Yelf, chief executive of the charity Macular Society, said they are receiving dozens of phone calls each month from people who are worried that they are going to lose vision because of delays.
Miss Yelf said: ‘People are terrified at the prospect of losing vision. The ones who contact us are the ones who are actively trying to solve the problem.
‘We have no idea how many people sit at home, quietly losing their vision and not making a fuss about it.
‘It is a tragedy that people lose sight when there is a treatment that will help keep their vision for longer, but it is not given in time.
‘If the NHS can’t cope with the number of patients then they should be assessing the risk of each patient, and find an alternative place for their treatment.
‘This can’t wait, this is an urgent situation and people will lose their vision if they are not treated properly.’
A Department of Health and Social Care spokesperson said: ‘No one should have to suffer avoidable sight loss and we are taking action to improve access to services, including appointing a national clinical director for eye care to oversee the recovery and transformation of services so patients receive the care they need.
‘We are also investing in the ophthalmology workforce with more training places provided in 2022 – and even more planned for 2023 – alongside improved training for existing staff.
‘We have made strong progress in tackling the Covid backlogs – including those waiting for eye care – with a record 2.1 million diagnostic tests carried out in January.
‘Thousands more patients are now being seen more quickly and the number of 18-month waits have decreased by almost two thirds since September 2021.’