Optometric Aid

A recent study examining Welsh healthcare practices has explored the impact of shifting the management of neovascular age-related macular degeneration (nAMD) and glaucoma from hospital eye services (HES) to primary care optometrists. With hospital services facing increasing demand and longer waiting times in the UK, integrating optometrists into the care pathway could offer significant benefits to both patients and healthcare systems.

Conducted by The Royal College of Optometrists, the study evaluated seven enhanced optometric service pathways – three for nAMD and four for glaucoma – through a mixed-methods approach, including patient experience surveys, economic simulations, and workforce assessments. The results demonstrated that utilizing optometrists in primary care significantly reduced wait times for diagnosis and monitoring. For suspected nAMD cases, waiting times were recorded as having dropped to four-five days compared to lengthy hospital queues. Similarly, glaucoma patients experienced shorter waits of just five days, down from the typical two-year waiting period observed in hospital settings.

Patient satisfaction with primary care optometry services was found to be comparable to that of hospital services. Optometrists demonstrated the necessary qualifications and willingness to take on these expanded roles. Furthermore, the study found that consultant ophthalmologists' involvement in routine care decreased from 57 percent to 15 percent in nAMD services, and from 48 percent to 22 percent in glaucoma services, freeing up their time to focus on more complex cases.

Despite these identified benefits, challenges such as administrative coordination, IT support, and financial sustainability were also highlighted. The study emphasized that successful implementation requires clear communication between primary and secondary care providers, efficient referral systems, and strong administrative support to ensure seamless patient care.

If these challenges are addressed, the authors believe the study findings support expanding these services across Wales and potentially beyond, offering a scalable model to address the growing demands in ophthalmology.