Optometrists call for expansion of eye-care services in the Community

Optometrists urge quicker patient access to eye-care

Optometrists have called for a new Contract for public eye-care and expansion of services accessed in the community – following the approach used in other European countries.

Speaking at a European Council of Optometry and Optics (ECOO) meeting in Dublin today (Friday, May 13) hosted by Optometry Ireland, and addressed by the Minister for Health Stephen Donnelly, Optometrists said Ireland’s hospital-centric model of public eye-care was outdated and resulting in unacceptable delay.

Optometry Ireland President John Weldon said patients are being diagnosed too late and waiting too long for treatment which was damaging their health, reducing their independence and compromising quality of life.

However, he said this could be addressed by looking at how public eye-care services are provided in other European countries and adapting that model here.

“A lot more diagnosis, treatment, prescribing and monitoring of eye diseases and conditions can be provided in the community by Optometrists under public contract. We can learn from other European countries who have adapted this model of care. This can be done without much difficulty and is more cost effective.

“We need to triage public eye-care, with more routine services accessible at local Optometrists, and hospital Ophthalmology departments dedicated to specialist and complex care.

“Other member countries across Europe, attending today’s Optometry and Optics meeting, are already applying this model. We are asking Minister Donnelly and his Officials to take notice and commit to implementing a similar model of care here.”

The Minister for Health Stephen Donnelly provided a video message to the meeting and said that Community Optometrists were pivotal to the delivery of core eye-care services and have the potential to play an even greater role.

“My officials are working with their counterparts in the HSE with a view to contracting more services to community Optometrists. Embedded in communities, local Optometry practices ensure access to care near people’s homes, and reform in eye-care must build upon those foundations.

“The policy of shifting care to community professionals is a core pillar of Sláintecare’s ten-year programme to transform our health and social care services.”

Optometry Ireland CEO Seán McCrave said the need for a new public services agreement has previously been acknowledged by Minister Donnelly and senior Department Officials at meetings, and stressed the need to now make real progress.

“There have been major changes in Optometry. Techniques have changed and treatments have expanded. Equipment and technology have transformed. Our 23 year old Contract does not recognise these changes, and so doesn’t provide a meaningful reference for what Optometrists can and should provide.”

National Treatment Purchase Fund (NTPF) Waiting List figures to the end of March 2022 show more than 38,500 on the outpatient eye-care waiting list and 8,500 on the inpatient waiting list.

Optometry Ireland highlighted six priority changes that could be addressed in a new contract – and which would help to achieve earlier diagnosis and treatment for the public.

1. National roll out of the award-winning Sligo Cataract scheme where Optometrists refer cataract patients directly to public hospitals and review post cataract patients. This would reduce the costs incurred by the National Treatment Purchase Fund (NTPF) and cross border schemes and bring improved use of Optometrists and Eye Surgeons skillsets.
2. Nationwide roll out of a children’s eye-care scheme where eye examinations and care for over six year olds is led by Optometrists who manage cases where medical examinations and treatments are not required, and triage and refer those which do.
3. Authorising Optometrists to directly refer Medical Card patients to A&E without GP involvement, or charge to a patient. This would reduce the need for patients to be redirected to GPs with cost savings.
4. Sanction Optometrists to provide the public treatment of additional conditions such as stable glaucoma, dry eye and dry macular degeneration. Doing so is within the scope of Optometrists training and would reduce hospital waiting lists.
5. Remove current restrictions on Optometrists prescribing of medications and enable them to do so to the full extent of their training and qualifications.
6. Sanction short hospital rotations as part of the training undergraduate students of Optometry, to better integrate hospital and community services.

John Weldon concluded: “A new Optometrists’ contract, which follows the community led model of our European partners, would significantly improve outcomes for our population. With relatively little intervention or overall change to costs, these improvements can be readily implemented.

“We are calling on the Minister to progress work on a new Contract and to providing more care in the community by engaging with our profession. As the Minister himself states doing so is fully in line with the principles of Sláintecare, the State’s health policy.”

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