1. THE PREVENTION AGENDA

2. Scotland is widely acknowledged as a world leader in eye health care services

3. The figures Over 263,000 people have diabetes 49,000 have diabetes and don’t know it 620,000 are at high risk We currently have no systematic, sustained approach to identifying undiagnosed and at high risk We have an ageing population Three out of four blind or partially sighted older people live in poverty or less than half the mean national income

4. International research has shown a four fold return on investment in early eye care intervention Both smoking and obesity can double the probability of sight loss. Scotland has the second highest level of obesity in the developed world [after America]. Adult smoking rates remain consistently higher in Scotland than in England and Wales.

5. Diabetic retinopathy is the single biggest cause of sight loss amongst Scots of working age. People of South Asian origin are six times more likely to develop Type 2 diabetes than Caucasians. Those of African Caribbean origin are three times more likely. Some forms of glaucoma are more than three times more prevalent among people of Afro/Caribbean and Chinese descent.

6. The figures 28% have retinopathy in one or both eyes In 2003 this was 14.4% Uncertainty in the system ‘not known’ has decreased from 34.7% to 7.6%

8. The figures However, 41,052 people are not included at present 35,500 are not tested within 15 months Eligible population – 16-30% DNA rate [mainly Type 1]

10. DNA and Type 1 Major issue across all services but particularly footcare and retinopathy The is despite the retinopathy service being rated the highest for quality by people with diabetes Type 1 HbA1C - worst in Europe Working with the DRS and Borders Managed Clinical Network to find out why There are over 1,400 young people with sight loss in Scotland

11. Treatment - Lucentis Treatment for diabetic macular oedema Approved by SMC in 2012 Some health boards delivering – most are not Cost of Lucentis is covered – but not staffing capacity and/or training Have asked for clarification of delivery on this

12. Why the strategy is important Eliminate avoidable sight loss Pull together the factors that can lead to sight loss – health in general, smoking, obesity Tackle the inequalities – employment, deprivation, access to services Partnership working Build on the progress made so far

13. Thank you – and looking forward to working together on delivering the strategy.