Dr. Abhishek Mandal, Ph.D.
Senior Business Adviser, Vision Science Academy, London, U.K.
Vision Science Academy Exclusive
A satisfactory visual health is deemed highly essential for the execution of our daily physical activities. Impaired vision, on the contrary, can have a potentially catastrophic impact on an individual’s affairs of psychosocial, occupational and socioeconomic concern (Cumberland et al., 2016). Nonetheless, gradual loss of vision is a health disorder which can be generally prevented through a plethora of pathways.
In the United Kingdom, NHS provides a well-structured and life-long screening approach for individuals who stand at high risk for a progressive decline in vision. Some instances include diabetic retinopathy and age-related macular degeneration (AMD). However, there are a multitude of factors which can significantly modulate the public compliance to eye screening programs. These factors include the effectiveness of interactions between the healthcare screening staff and patients, quality of patient education and psychosocial support from the patients’ relatives. In line with this, an insufficient interpersonal communication between the healthcare provider and patient can significantly impact patient adherence to eye screening (Mat Isa et al., 2021). A higher level of patient education and reasonable socioeconomic status also contribute to a greater extent of compliance to screening. Besides, busy daytime working hours or poor awareness can hinder routine eye screening (Isa et al., 2021) (Figure 1).
Figure 1. Barriers in the Implementation of Eye Screening
During the COVID-19 pandemic, NHS suffered from a significant lapse in provision of both emergency and outpatient services related to eye care. Despite the limited use of virtual or remote screening tools, hundreds of individuals missed their screening appointments for vision which led to certain adverse yet preventable outcomes. More than 6,000 individuals missed their referral for monitoring of potentially deteriorating diabetic retinopathy whereas the missing referral count crossed 10,000 in case of AMD screening. Besides screening, it has been estimated that 2,600 individuals failed to receive a timely appointment and treatment for suspected glaucoma. Moreover, time delays in eye screening skyrocketed to 1 year or even longer. Similarly, a significantly less number of minor ophthalmological procedures were carried out during this period. Furthermore, the unfortunate outcome in the form of blindness was encountered in up to 2,986 individuals during the course of the pandemic (The State of the UK’s Eye Health 2021, 2021) (Figure 2).
Given the fact that NHS is still in the post-COVID recovery phase, there is an urgent need to stabilize the community eye screening processes. The waiting intervals for eye appointments need to be optimized. Moreover, the overall scope for patient teaching sessions needs to be broadly enhanced so as to educate them to follow screening examinations routinely. Otherwise, individuals can potentially fail to present themselves for screening during the early, asymptomatic stages of a chronic illness (Hayden et al., 2012).
An important maneuver for promoting patient attendance during visual screening is to ensure booking appointments with the same optometrist or eye specialist. It is noteworthy that a strong rapport between patients and healthcare professionals can substantially boost screening compliance.
Cumberland, P. M., Rahi, J. S., Eye, f. t. U. B., & Consortium, V. (2016). Visual Function, Social Position, and Health and Life Chances: The UK Biobank Study. JAMA Ophthalmology, 134(9), 959-966. https://doi.org/10.1001/jamaophthalmol.2016.1778
Hayden, C., Hayden, C., & Intelligence, S. (2012). The barriers and enablers that affect access to primary and secondary eye care services across England, Wales, Scotland and Northern Ireland. CEP/IR/01.
Isa, R. a. M., Saidi, S., Salam, A., Nurumal, M. S., & Jamaludin, T. S. S. (2021). A cross-sectional study on factors influencing attendance to eye screening. Enfermería Clínica, 31, S321-S325. https://doi.org/https://doi.org/10.1016/j.enfcli.2020.12.037
Mat Isa, R. a., Saidi, S., Salam, A., & Jamaludin, T. S. S. (2021). Attendance to Eye Screening from The Eye of Healthcare Professionals: A Qualitative Finding. INTERNATIONAL JOURNAL OF CARE SCHOLARS, 4(2), 40-48. https://doi.org/10.31436/ijcs.v4i2.179
The State of the UK’s Eye Health 2021. (2021). Specsavers.https://content.specsavers.com/state-of-the-nation/FINAL_Digital_The+state+of+the+UK%E2%80%99s+Eye+Health+2021.pdf