OPHTHALMOLOGY
Some waiting five years for cataract surgery
May 16, 2018
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Some people are having to wait up to five years for cataract surgery in the public health service, a new survey has revealed.
The wait time for private patients is three months.
The survey was carried out by the Association of Optometrists Ireland (AOI) and according to the findings, the average wait for public cataract surgery nationwide is two years and four months. However in west Cork, the wait is five years.
The shortest wait - one year and three months - is in Sligo and Leitrim. That area has a scheme in place that involves increased co-working between optometrists and the hospital eye department.
The survey also looked at children's eye care and again, major inconsistencies were found nationwide. While the average wait for public eye care for children under the age of 12 was one year and three months, this ranged from a five-month wait in Cavan and Monaghan to a two-year wait in east Cork.
The survey of hundreds of practicing optometrists broke down responses per constituency. It revealed that in 36 of the 40 constituencies, the vision screening service previously offered in sixth class had ceased.
Alternative local arrangements had been put in place in just nine of these constituencies. The AOI noted that in 2016, the HSE wrote to local health offices recommending the end of the sixth-class service and stating that alternative local arrangements would be developed.
For those aged between 12 and 16, the survey found that local HSE offices will not authorise public eye care in 19 of the 40 constituencies for children who have their own medical cards, while local arrangements are in place in 21 constituencies.
AOI president, Triona Culliton, called on the Minister for Health, Simon Harris, to intervene and bring about an overhaul of eye care services. She insisted that Ireland is over reliant on HSE eye clinics and hospital ophthalmology departments to provide almost all public care, even basic and routine care that could be offered by optometrists.
"Optometrists can provide routine care such as eye examinations, glasses fitting, and pre- and post-surgery check-ups in the community. Only more complex cases need to be referred to our colleagues in HSE eye clinics or hospital eye departments. This is the model widely and successfully in operation across the UK and Europe," Ms Culliton noted.
She pointed out that when it comes to cataract surgery, the Sligo-Leitrim constituency has the shortest waiting time ‘and this is the core region where the award-winning Sligo Cataract Scheme is in operation'.
"The AOI has estimated that rolling out the scheme nationwide could save up to 20,000 hospital appointments per annum and reduce system costs. We are calling on Minister Harris to sanction the HSE to roll out this scheme nationwide immediately," she said.
The AOI is also calling for the introduction of a national eye care scheme for children up to the age of 16.
"Optometrists in the community should deliver eye examinations and spectacles fittings, while medical cases requiring surgical management are referred to eye doctors," Ms Culliton insisted.
The survey had asked AOI members if they would be willing to contribute towards relieving pressure on overburdened hospitals and clinics and 97% said they were immediately available to deliver the Sligo Cataract Scheme. A further 87% said they would support the non-medical and non-surgical elements of a national eye care programme for children.
Currently in Ireland, there are 41,000 patients on the ophthalmology outpatient waiting list, an 18% increase since the end of March 2017. There are also 11,000 on the ophthalmology inpatient waiting list - the second largest waiting list in any medical area.
The AOI pointed out that it has 650 trained optometrists working in 350 locations nationwide who could meet all clinical requirements necessary, and most already have the necessary equipment that they need.
The association said it is 50% cheaper for a patient to be seen in their community than at a HSE clinic or hospital. It has estimated that annual savings of €32.3 million could be made if reforms were introduced."The AOI is calling on the HSE, under the leadership of Minister Simon Harris, to reform Irish eye care and better serve the interest of patients. It is time that we stopped tolerating these terrible delays and take action," Ms Culliton added.