Some waiting five years for cataract surgery

Optometrists call for overhaul of eye services
  • Deborah Condon

The average waiting time for cataract surgery in Ireland is almost two-and-a-half years, with some people having to wait up to five years, a new survey has revealed.

The survey by the Association of Optometrists (AOI) looked at public and private waiting times for cataract surgery in constituencies nationwide and found that the average wait was 29 months.

The longest wait was in Cork, particularly west Cork, where patients faced a 60-month wait.

The shortest wait was in the Sligo and Leitrim constituency where patients had a 14-month wait. This area currently has in place a scheme, which sees optometrists and the hospital eye department working together to reduce waiting lists.

Meanwhile, the survey also found that the average waiting time for private cataract surgery was just three months.

It also noted that optometrists in every constituency said they were aware of patients availing of the Cross Border Directive for cataract surgery. This directive allows EU residents to access health services in EU member states other than their own.

Some 74% of optometrists reported an increase in patients travelling to Northern Ireland to avail of this directive in the last year.

The survey of hundreds of optometrists also looked at the issue of children's eye care. It found major variations in the services available depending on location.

For example, while the average wait for public eye care for children under 12 was 14 months, this ranged from three months in Tipperary to 25 months in Wexford.

There seemed to be some confusion on what services, if any, optometrists could offer to children in the public service.

Some 62% of optometrists said that their local HSE office/clinic did not have arrangements for them to provide an eye examination to children aged between eight and 12 if discharged from the HSE service, while 27% did. A further 11% were not clear about the local arrangement in their area.

Furthermore, 37% said that their local HSE Office would not authorise optometrists to examine children aged 12-16 who have a medical card, while 53% said the HSE would authorise it. A further 10% were not clear on the local protocol.

According to AOI president, Patricia Dunphy, the survey shows that eye care services are in need of a major overhaul. She said the main reason for the long waiting times was an ‘over-reliance on public eye clinics and hospital ophthalmology departments to provide even the most basic care'.

"Optometrists can provide routine eye examinations, glasses fitting, and pre and post-surgery check-ups in the community. Only more complex cases need be referred to clinics or hospitals. This is the model in operation across the UK and Europe and the one Ireland needs," Ms Dunphy insisted.

She said that a core priority should be the roll-out of the award winning Sligo Cataract Scheme nationwide, which sees optometrists and hospital eye departments working more closely together.

She also called for the roll-out of a national scheme that would allow children up to the age of 16, who do not need medical or surgical management, to be examined by optometrists in the community when necessary.

The AOI pointed out that the eye care capacity crisis is reflected in the waiting figures from the National Treatment Purchase Fund. They show that at the end of April 2019, there were 42,700 patients on the ophthalmology outpatient waiting list, and 9,000 on the inpatient waiting list, which is the third largest of any medical specialty.

According to AOI chief executive, Sean McCrave, there are over 650 trained optometrists working in 350 locations nationwide who could help deal with these ‘terrible delays'.

"The AOI has estimated that in excess of €30 million could be saved while at the same time delivering an accessible and clinically effective service. That is because it is 50% less expensive to provide care in the community than in hospital, and eliminating waiting times would lead to earlier detection and treatment," he commented.

He noted that in Scotland, optometrists ‘are utilised as the front line for public eye care and they do not have waiting list problems'.

"The AOI is calling on the HSE, under the leadership of the Minister for Health Simon Harris, to reform Irish eye care and better serve the interest of patients," Mr McCrave added.


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