The Royal College of Ophthalmologists have recently warned that NHS patients are being exposed to a risk of losing their vision, due to an increased demand and staffing capacity issues with eye services in the NHS.

Each month 20 patients in the UK with conditions such as Age-related Macular Degeneration (AMD) and glaucoma suffer avoidable loss of vision as a result of widespread delays in follow-up appointments.

Who is at risk?

There are a number of eye diseases which are more commonly found in the elderly and, consequently, the UK's ageing population has led to an increased demand for NHS eye services. This pressure has led to a delay in out-patient eye clinic appointments.

Hospitals are issued with a fine if patients are not referred for a consultation or treatment within 18 weeks after being referred by their GP. However, this only applies to new referrals and not to patients awaiting follow-up appointments, despite those being the category of patients who are more likely to suffer a sight-threatening condition than new referrals patients.

Why are eye services under pressure?

The increasing demand in NHS eye services stems from an influx of patients with chronic eye diseases such as macular degeneration, glaucoma and diabetic (retinopathy) eye disease.

These patients are more vulnerable to losing their vision and are at greater risk of irreversible loss of vision and, therefore, require long term follow-up appointments to manage their conditions, to ensure that they are monitored adequately and that treatment is administered when required.

Sadly, the reality is that these follow up appointments are often considered 'low priority' and are often delayed. In some cases, they have been described as being 'lost to the system' for months and even years, in order to free up capacity for new referrals in eye clinics, which are already oversubscribed.

New developments in eye treatment

Medical advances in eye care mean that some conditions, which were previously untreatable, can now be treated successfully, adding to rising demand in eye care services.

Statistics revealed by the Royal College of Ophthalmologists suggest that there has been a 30% increase in eye clinic attendances over the last five years.

Last year, a CQC inspection at Addenbrooke's Hospital, part of Cambridge University Hospitals NHS Foundation Trust, reported findings of unsafe delays to ophthalmic follow-up in clinics, causing serious incidents and harm. The preliminary results from a subsequent unreported study undertaken by the Royal College of Ophthalmologists has suggested that in the UK, at least 20 patients per month suffer severe visual loss and that these patients range from age seven months to 92 years of age. Delays for follow-up appointments of up to four years have been reported, as part of the study.

Types of eye condition

An untreated eye condition can deteriorate within days and in the worst case scenario can lead to a total loss of vision. The key to avoiding a total loss of vision is regular monitoring and administration of treatment, where appropriate.

The following is a brief guide to eye conditions and the consequences of a failure to provide adequate treatment to patients.

Glaucoma

Glaucoma is a condition which can seriously affect sight, usually due to a build-up of pressure in the eye. Any damage to vision caused by glaucoma cannot be repaired, so early diagnosis and treatment of the condition is extremely important. In the UK, glaucoma is responsible for one in 10 cases of visual impairment. Careful monitoring of the condition is imperative in minimising further damage.

Age-related Macular Degeneration (AMD)

Age-related macular degeneration (AMD) is a painless eye condition which causes you to lose central vision, usually in both eyes. Generally this occurs gradually; however, in some circumstances; rapid deterioration can occur.

Age-related macular degeneration rarely affects your peripheral vision; however, complications can occur, causing a total loss of vision and, therefore, close monitoring is important.

Although there is no cure for age-related macular degeneration, failure to treat the condition promptly can lead to avoidable and premature permanent loss of vision in the affected eye.

Diabetic Retinopathy

Diabetic eye disease (retinopathy) is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina). If the condition is left undiagnosed or untreated, this can lead to a total loss of vision. Generally, loss of vision is only a risk in patients with advanced diabetic eye disease. Regular screening appointments are offered to patients with diabetes in order to diagnose the condition and there are a number of treatment options available.

Delays in diagnosing an eye condition and administering proper treatment could lead to avoidable harm, including partial or complete loss of vision.