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

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

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.

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

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

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

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

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.

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

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

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% 18-74 year olds SOURCE: NATIONAL STATISTICS 2008,COUNCIL TABLES- BLIND AND PARTIALLY SIGHTED, PB1

Local picture of XXXX Predictions of the number of people in XXXX using POPPI (Projecting Older People Population Information) www.poppi.org.uk PANSI (Projecting Adult Needs & Service Information) www.pansi.org.uk 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

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.

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; www.locsu.co.uk

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

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

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

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

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.

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

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.

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.

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

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

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

References http://www.dh.gov.uk/health/2012/09/program me-budgeting-guidance/ www.vision2020uk.org.uk www.rnib.org.uk/datatool sight loss data tool http://www.rnib.org.uk/aboutus/Research/statist ics/Pages/sight-loss-datatool.aspx http://www.commissioningforeyecare.org.uk/ http://www.locsu.co.uk/enhanced-services- pathways/

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