1 / 30

Preventing Avoidable Sight Loss - A Public Health Challenge

Preventing Avoidable Sight Loss - A Public Health Challenge Sian Biddyr: Eye Health Promotion Manager, RNIB Cymru Helen Lee: Public Health Development Manager, RNIB London. How many blind and partially sighted people are there?. Sight loss is a major health issue. In the UK

dakota
Download Presentation

Preventing Avoidable Sight Loss - A Public Health Challenge

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Preventing Avoidable Sight Loss - A Public Health Challenge • Sian Biddyr: Eye Health Promotion Manager, • RNIB Cymru • Helen Lee: Public Health Development Manager, • RNIB London

  2. How many blind and partially sighted people are there? • Sight loss is a major health issue. • In the UK • 182,000 have severe sight impairment/blindness • 300,000 registered blind or partially sighted • 2,000,000 with significant sight loss • In Wales • 16,000 are registered blind or partially sighted • 115,000 with significant sight loss • Access Economics (2009)

  3. Causes of blindness amongst adults in the UK Access Economics (2009)

  4. Demographic Time Bomb! Without action - In the UK, the number of people with significant sight loss will double from 2 to 4 m, between 2008 to 2050. In Wales the figure at 2050 will be 300,000.

  5. Morbidity and quality of life • Ranks among top ten causes of disability • Increased morbidity • Decreased quality of life, impact in individuals families and society as a whole • Adverse impact on activities of daily living • Causes falls and injuries • Leads to depression • Leads to social isolation • Sight loss is one of top three causes of suicide amongst older people (Waern et al, 2000)

  6. Sightloss simulation Glaucoma AMD Stroke

  7. People most at risk of sightloss • 1 in 5 people aged over 75 • 1 in 2 people aged over 90 are living with sight loss • People from various BME communities • People with a family history of eye conditions such as glaucoma, diabetic retinopathy etc • People with learning difficulties are 10 times more likely to be sight impaired

  8. Socio-economic deprivation & sightloss • Chronic eye disease is worse in areas of multiple deprivation and low income (World Health Assembly Vision 2020 Resolution 2006) • People living in deprivation are less likely to access primary eye care services (Dickey et al 2007) • Association between severity of glaucoma at presentation with socio-economic deprivation (Johnson et al 2011) • Proximity to primary eye care services is associated with poorer visual acuity in presentation of AMD (Johnson et al 2011)

  9. Diabetes, a public health issue Diabetic Retinopathy is the leading cause of blindness in the working age population. There are 2.9m people diagnosed with diabetes in the UK - set to double in next 20 years. Diabetics are x25 more likely than the general public to become blind. The South Asian population is five times more likely to have diabetes than white British population. Early diagnosis and treatment can prevent up to 98% of severe vision loss.

  10. Diabetic Retinopathy Simulation

  11. Impact of sightloss on NHS in Wales • Sight loss costs the NHS in Wales an estimated £107 million in direct costs (eg, in patient treatments, outpatient attendances, prescriptions and NHS funded eye tests) • Double in next 20 years (Frick and Foster 2003) • Estimated annual costs for sight loss in Wales including direct and indirect costs is £324 million. (ref for all above, Access Economics 2009) • Frick and Kymes (2006) state the economic burden of sight loss similar to that of cancer, dementia and arthritis • Prevalence of visual impairment increases with age (WHO 2007)

  12. And now the good news…. • 50% of sight loss is avoidable! • Due to preventable or treatable causes • Early detection and treatment • AMD • Cataracts • Glaucoma • Diabetic retinopathy • Refraction

  13. Regular eye examinations - early detection • Regular sight tests help maintain good eye health, particularly for those most at risk • Important as some serious eye conditions do not have visible warning signs (eg glaucoma) • Early detection will also enable more to be done to delay disease progression. • Sight test with an optometrist at least every two years. • RNIB recommends an annual sight test for children up to sixteen and annually for people 60 years+.

  14. NHS Sight Tests and Wales Eye Care Initiative • NHS sight tests are free for: • People aged 60 years +, children under 16 years or up to 19 years in full time education, 40 years + with family history of glaucoma, on low income. • Wales Eye Care Initiative (WECI) • Optometrists who have signed up to WECI provide various free eye examinations for: • People who have sight in one eye, hearing impairment or profoundly deaf, suffer from retinitis pigmentosa, have family origins from various BME communities, are a risk of eye disease by other reasons of race or family history.

  15. Uptake of NHS sight tests in Wales for 60 years+ General Ophthalmic Services (GOS) statistics

  16. Map showing uptake of NHS sight tests for 60 years+ in Wales 2010/11

  17. Uptake of NHS sight tests in Wales - Children 3-15 years, GOS statistics

  18. Map showing uptake of children 3-15 years NHS sight tests in Wales 2010/11

  19. Primary prevention - maintaining healthy eyes • In additions to going for regular checks, what else can we do to promote healthy eyes?: • Smoking doubles risk of AMD • Healthy weight reduces risk of diabetes • Low fat diet, rich in green leafy vegetables may protect against cataracts and AMD • Wearing sunglasses may reduce risk cataracts • Protective goggles can help avoid thousands of DIY and sports injuries annually.

  20. Developing evidence of what works 20

  21. Equity profile - needs assessment • RNIB commissioned the public health observatory to carry out an eye health equity profile for Cwm Taf 2011. • Includes description of population • Epidemiology of different eye conditions • Provision of services in Cwm Taf • Provision of services in relation to need • Document also provides information for wider health strategy of Cwm Taf Health Board with the aim of producing equity, outcomes and quality of life for people with or at risk of poor eye health. • Copy can be downloaded from Public Health Observatory's website

  22. What's happening in Wales? • An eye care strategy called the UK Vision Strategy was developed in 2008 in response to the World Health Assembly Vision 2020 resolution. • Five year plan • Wales Vision Strategy Advisory Group of eye care partners, produced an implementation plan in June 2010 to deliver against three main objectives: • To improve the eye health of people in Wales • To eliminate avoidable sight loss and support people with sight loss • Inclusion, participation and independence for people with sight loss. • All work on sight loss prevention enhances progress to achieving first two of these objectives

  23. What's happening in Wales? • Wales Eye Health Project - objectives, data, patient feedback highlighted issues around waiting times, accessibility • Older people and eye health - barriers and enablers to sight tests • National Eye Health Week • Pilot project about babies eye health • Projects that focus on different eye conditions e.g. Glaucoma Alliance and Focus On Ophthalmology • Megafocus • Links to other areas - falls, stroke • Raising awareness with partners and AMs of impact of sight loss - Cross Party Vision Group, Stroke Group • Diabetic Retinopathy Screening Services for Wales

  24. However! - in reviewing 22 Health Social Care and Wellbeing Strategies in Wales 2011 only two authorities highlighted the importance of sight loss prevention! • Sight loss prevention also not given priority in Directors of Public Health Annual Reports

  25. If 50% of sight loss is avoidable, what can be done? • There are many routes to bring about change… • Integrate eye health into public health messages and into priority areas of work - eg smoking, falls, screening etc • Ensure vision screening for children • Identify at-risk populations and target • Integrate eye health into needs assessments and local HSCWB strategies • Timely access to diagnosis and treatment • Work towards objectives in Wales Vision Strategy plan • Support NEHW and other eye health campaigns

  26. References • Access Economics (2009) Future Sight Loss UK 1: The economic impact of partial sight and blindness in the UK adult population. RNIB • http://www.rnib.org.uk/aboutus/Research/reports/prevention/Pages/fsluk1.aspx • Burmedi D, Becker S, Heyl V, Wahl HW, and Himmelsback (2002) 'Emotional and social consequences of age-related low vision: a narrative review', Partial sight and blindness research Vol. 4, No1, pp 47-71 • Dickey et al, (2007) Utilisation of eye-care services: An examination of the effect of Scotland’s free eye examination policy. Scotland: University of Aberdeen. • Hayden, (2012) RNIB Community Engagement Project Insight Research – National report. UK: RNIB • http://www.rnib.org.uk/aboutus/Research/reports/prevention/Pages/CEP_barriers_enablers.aspx

  27. References • Johnson et al (2011) A review of evidence to evaluate effectiveness of intervention strategies to address inequalities in eye health care. • http://www.rnib.org.uk/aboutus/Research/reports/prevention/Pages/evaluation_interventions.aspx • Legood et al. (2002): Are we blind to injuries in the visually impaired? A review of the literature, Injury Prevention. • RNIB (2011) Preventing Sight Loss in Older People: barriers and enablers to the uptake of sight tests in older people • RNIB (2012) Preventing Avoidable Sight Loss. Developing an evidence base to build better eye care services. • http://rnib.org.uk/PROFESSIONALS/HEALTH/SERVICES/Pages/optometrists.aspx • Waern et al (2000) Burden of illness and suicide in elderly people:case control study BMJ June 2002

  28. Eye health - a public health priority • How can we further incorporate eye • health into public health programmes of • work?

  29. Workshop Activity • 1. Which current/forthcoming public health priorities could incorporate eye health? • List up to three areas • 2. How would you do this? • 3. What resources or support would you need?

  30. Contact Details • Sian Biddyr • RNIB Cymru • Eye Health Promotion Manager • Tel: 029 20 449495 • Email: sian.biddyr@rnib.org.uk • Helen Lee • RNIB • Public Health Development Manager • Tel: 0207 874 1347 • Email: helen.lee@rnib.org.uk

More Related