Light at the end of the tunnel

Knowing what to expect from eye care professionals depends on good communication which can empower and reassure patients, as Liz Bestic discovers

A recent report by the Royal National Institute of Blind People (RNIB), entitled Preventing Avoidable Sight Loss, touched on a lack of communication between optometrists and their patients. Some of the problems were recognised in the UK Vision Strategy launched in 2008.

This aimed to bring together, for the first time, users of eye care services and professionals from the health and voluntary sectors with government to produce a unified plan for action on all issues relating to vision in the UK.

On the back of the new strategy, You and Your Vision – A Charter for Eye Care and Sight Loss Services was launched outlining, in clear and jargon-free language, what people should expect on their eye care journey from the first visit to an opticians to seeing a consultant ophthalmologist in a hospital eye department.

“There was a concern that some people were walking away from their hospital appointments not really understanding what was wrong with their eyes or what would happen next,” says Anita Lightstone, programme director of UK Vision Strategy.

“’You and Your Vision’ tells you what to expect from a quality service so you come away from your appointment with the eye doctor knowing what’s wrong with your eyes, when your next appointment is going to be and knowing you can take someone with you to your consultation,” says Ms Lightstone.

Waiting times for cataract surgery have improved enormously

Eye disease, as opposed to sight conditions resulting in the need for glasses, is generally managed at the hospital by consultant ophthalmologists. These are the doctors who manage serious eye conditions such as cataracts, age-related macular degeneration (AMD) and glaucoma. They also perform operations on the eye.

Optometrists test the eyes and ensure they are healthy. However, they are getting more and more involved in the routine monitoring of conditions such as glaucoma.

Other professionals concerned with eye care are orthoptists, who are qualified to identify and treat certain eye conditions, such as a squint or double vision. They work mainly with the ophthalmologists and ophthalmic nurses involved in specialist eye care.

Amanda Hayhurst from the Royal College of Ophthalmologists believes things have changed for the better. “There was recognition that ophthalmologists needed better communication skills particularly when breaking bad news,” she says.

‘It can be devastating to be told you are going blind but, even where there may be no treatment, the focus now is very much on what can be done in terms of rehabilitation, low vision clinics and social services support.

“Nowadays, a large part of the examination to become a qualified ophthalmologist involves role playing a variety of scenarios, including those where you may have to break bad news to a patient.”

The number of people in the UK with sight loss is set to double to nearly four million by 2050. “Too many people are losing their sight when it is avoidable,” says Ms Lightstone. “Already there are around two million people in the UK with some degree of sight loss. About 50 per cent of those are living with sight loss when it could be avoided.”

London-based optometrist Roger Pope stresses the importance of a good quality eye examination. “It’s not just about keeping your eyes in good shape, it can also act as an early warning system,” he says.

According to Ms Lightstone, eye care services are improving slowly. “Waiting times for cataract surgery have improved enormously and eye care professionals are working better together to provide more patient-focused care in many areas of the UK,” she says.

“Part of our job is to bring eye care to the top of the political and public agenda so that people understand they should be looking after their eyes, having routine eye tests and taking their eye health seriously. However, the other side of that is to get professionals together to ensure clear and effective patient care pathways.”