1. EYECARE about the HEALTH and WELLBEING of the people of XXXX
Optometrist, BSc(Hons), MCOptom
Member of XXXX Local Optical Committee
Add name of Health & Well Being Board area + LOC

2. What is an Optometrist?
A primary health care professional with a specialist training in the eyes who can:
assess and correct defects in vision
detect ocular disease, injury or abnormality
treat eye diseases within their competence
detect some disorders of general health which can manifest within the eye

3. Attaining qualification
A three-year undergraduate study at University leading to a BSc, and/or a BCOptom.
Minimum of a one-year post-graduate qualification working under supervision with assessments and a final Objective Structured Clinical Examination (OSCE) through the College of Optometrists.

4. Regulation By the General Optical Council (GOC)
Registration on the Opticians Register is compulsory for optometrists to practice with an annual renewal
Specialist ocular therapeutics registers
There is a voluntary register for Dispensing Opticians with a separate register for dispensing opticians who can fit contact lenses

5. Continuing professional development
Continuing Education & Training (CET) is:
Regulated by the GOC
Mandatory over a 3-year cycle
Compulsory peer review
Involves a diverse range of competencies
College of Optometrists set standards & have developed various higher qualifications e.g:
Independent prescribing
Glaucoma

6. What can Optometrists do?
Refraction: assessment and correction of myopia (short-sight), hypermetropia (long sight), astigmatism (rugby ball shaped corneas) etc
Presbyopia - loss of ability to focus on near visual tasks
Squint/lazy eyes
Assess whether or not vision is adequate for driving - DVLA requirements

7. What else can Optometrists do?
Assess binocular vision
Assess colour vision
Fit Contact Lenses (CLs) (Optometrists or Dispensing Optician CL fitters)
Assess suitability for Low Vision Aids
Provide domiciliary eye care (additional service)
VDU assessments

8. What sort of eye disease can Optometrists detect?
Examples are:
Age Related Macular Degeneration (AMD)
Glaucoma
Diabetic retinopathy
Cataracts
Retinal/vitreous detachments
Dry eyes
Mention signs of hypertension, cardio/vascular disease & other system diseases (only part of the body where blood vessels can be viewed without surgery) even brain tumours & neurological diseases.

9. The importance of Eye Health
1.8 million people live with sight loss in the UK (Future sight loss UK, RNIB 2008)
By 2020 this will increase by 22%
Almost 4 million by 2050
Ophthalmology accounts for 8th highest level of programme spend in England and is rising

10. The importance of Eye Health
In 2010/2011 there were 6,365,308 out- patient attendances in England
4.5 million GP consultations/year include an eye problem
Direct cost around £26 billion/year
This is set to increase
Over 50% of sight loss is preventable

11. Age and Eye Health
Prevalence of many of the main causes of sight loss increase with age
Given current demographic trends, we are likely to see increasing levels of avoidable sight loss
Significant impact on future demand on health and social care services
64% of people certified as visually impaired (VI) are over 75 year olds and 32% year olds
SOURCE: NATIONAL STATISTICS 2008,COUNCIL TABLES- BLIND AND PARTIALLY SIGHTED, PB1

12. Local picture of XXXX
Predictions of the number of people in XXXX using
POPPI (Projecting Older People Population Information)
PANSI (Projecting Adult Needs & Service Information)
XXX people with serious visual impairment in XXX who require help with daily activities
This will slowly increase over the next few years
Add name of area & figures for those with a serious visual impairment + those who require help with daily activities

13. Some suggested solutions
Since 2004, the DoH has been trying to encourage the delivery of more routine and minor emergency eye care outside hospital in community optical practices.
The aim is to free up hospital capacity to cope with increasing demand from both the ageing population and new technologies e.g. wet AMD treatments.

14. What eye care can be provided in the community?
Minor Eye Conditions Service
Some Glaucoma Services
Pre & Post Operative Cataract Service
Children’s Vision Service
Low Vision Service
Eye Care Services for Adults & Young People with a Learning Disability
LOCSU pathways for all of these services available on website;

15. Benefits of Community Eye Care services
Supports national and local strategic priorities
Community rather than hospital care
Evidence based practice
Patient choice
Care closer to home

16. Referral to Ophthalmology in XXXX
GP- xxxx
Other - xxxx
Cost of first ophthalmology out-patient attendance in 2014 = £118.13
TOTAL REFERRALS TO OPHTHALMOLOGY
xxxx
SOURCE INFORMATION DEPARTMENT THE ROTEHRHAM NS FOUNDATION TRUST 2012
Add figures where required

17. What can Health & Wellbeing Boards do?
Make eye care and prevention of sight loss a priority for public health
Encourage Early Intervention
Encourage Clinical Commissioning Groups to increase the impact of their eye care commissioning strategy

18. Eye Health and Health & Wellbeing Boards
Health and wellbeing strategies that address some general public health issues also impact on eye health and support prevention of sight loss. The following are examples of links between public health and sight loss:
Smoking
Obesity
Diabetes

19. Smoking and Eye Health Age-Related Macular Degeneration (AMD)
As strong as the link with lung cancer
Doubles the risk
Develops at an earlier age
Stopping smoking reduces the risk
Treatment options for AMD are limited
Cataracts
Diabetes
Smoking: The link between smoking and age-related macular degeneration (AMD), the UK's leading cause of sight loss, is as strong as the link between smoking and lung cancer. Smoking causes harm to the tissues of the eye. Research has confirmed the harmful effects of smoking on eyesight, particularly in the development of AMD and cataracts. Smokers not only double their risk of developing AMD, they also tend to develop it earlier than non-smokers do. Treatment options for AMD are limited. It has been shown that stopping smoking can reduce the risk of macular degeneration developing. While cataracts are treatable and therefore do not lead to blindness, they remain a major cause of sight loss in the UK. Furthermore, smoking makes diabetes-related sight problems worse.

20. Obesity and Eye Health Diabetic retinopathy
increase risk of developing type 2 diabetes
Age-related macular degeneration (AMD)
obesity may increase the risk of developing dry AMD
also increases the speed of progression of AMD
Dry AMD is likely to impede the ability to carry out daily activities such as driving, reading a newspaper or watching television
Cataracts
can double the risk of developing cataracts

21. Diabetes and Eye Health
Diabetic Retinopathy
Good blood sugar control and good blood pressure control substantially reduce the risk of sight-threatening diabetic retinopathy.
Strategies that seek to prevent diabetes and improve the quality of diabetes care will help prevent avoidable diabetes related sight loss.

22. Other costs of Visual Impairment
Mental Health
Higher incidence of mental health issues in those suffering from sight loss.
Falls
Higher incidence of falls due to poor vision, cataracts etc.

23. We can help you to work with Health and Social Care providers
How can the LOC help?
We can help you to work with Health and Social Care providers
Encourage a multi-disciplinary approach
Early intervention
Quality, Innovation, Patient centred, Patient satisfaction, Patient choice
Improve efficiency and reduce costs

24. Current Community Eye Care Services
List all the community eye care services currently available in your area

25. The LOC aim
To work with the Health & Wellbeing Board and other partnership organisations to help deliver high quality and accessible eye care
Integrating service delivery with others
GPS
Ophthalmologists
Orthoptists
Nurses
Social Care personnel

26. References
me-budgeting-guidance/
sight loss data tool
ics/Pages/sight-loss-datatool.aspx
pathways/

27. Thank you for listening