Ireland's eye care services are in need of major reform if they are to keep up with the demands placed on them by an increasing and ageing population, experts have warned.

The latest waiting list figures show that at the end of August, there were 41,600 people waiting for outpatient eye care appointments, up from 40,000 at the same time in 2017 and 38,100 in 2016.

Of these 41,600 people, 16,100 have been waiting for more than one year, while 9,600 have been waiting for more than 18 months for their appointment.

A further 10,400 people were also waiting for inpatient eye procedures at the end of July. While this marked a small reduction in the number of people waiting for such procedures, it remains the second longest waiting inpatient list among all medical specialties.

As part of its pre-Budget submission, the Association of Optometrists (AOI) has called for major reform of eye care services, particularly in relation to outpatients lists, which it says, are ‘spiralling further out of control'.

"The AOI welcomes some additional theatre space at the Royal Victoria Eye and Ear and Nenagh Hospitals this year, but these will not address the scale of demand and delays.

"We are recommending radical reform of eye care to move towards a triaged pathway of routine public care provided in the community and specialised care in hospitals. In Ireland we have an unusual overreliance on hospital ophthalmology departments that will not meet the demands of our population," the AOI commented.

It highlighted, in particular, the need for better organisation of cataracts surgery, which accounts for a large portion of the waiting lists backlog.

"A survey carried out by the AOI earlier this year found that there are waiting times of up to five years in some parts of the country for cataract surgery. To address this we are calling for the national roll-out of the Sligo Post-Cataract Scheme, which has reduced waiting times and costs in the region where it is available.

"Under the scheme, patients' follow up appointments are co-managed by optometrists and ophthalmologists, reducing the care pathway by one appointment. With over 20,000 cataract procedures a year, rolling out this protocol nationally would reduce outpatient cataract appointments by up to 20,000. This alone would make a significant impact," explained AOI chief executive, Sean McCrave.

As part of its pre-Budget submission, the AOI is also calling for the rollout of an optometrist-led national eye care programme for children up to the age of 16 years, in order to address major waiting times and inconsistencies in children's services.

Mr Crave suggested that there are also other areas where optometry could help reduce waiting lists, such as red eye management and glaucoma.

"Not all these patients need to be under the full-time care of ophthalmology. Hospital waiting lists can be reduced further by directing some of these patients back into the community.

"The AOI has estimated that in excess of €30 million could be saved across services, while at the same time delivering a more accessible and clinically effective service. That is because it is 50% less expensive to provide routine examinations, monitoring and care in the community than in the hospital system," he added.

Budget 2019 will be announced on October 9.