MORE THAN 50,000 people are waiting for eye care appointments from the HSE, including patients with deteriorating conditions such as glaucoma, while concerns are also being raised that treatments and procedures will be further delayed as a result of Covid-19.

The latest figures from the Department of Health show that 41,401 people are waiting for an outpatient appointment, with 12,414 of those waiting more than 18 months for their appointment.

A further 9,822 people are also waiting for inpatient appointments for treatments and procedures.

Lynda McGivney Nolan, an optometric advisor with the Association of Optometrists Ireland (AOI) with a practice in Bray, suggested that those figures could be revised upwards in the coming months as the HSE takes stock of those patients who had appointments cancelled due to Covid-19, along with an influx of new referrals.

“I would suspect, very strongly, that those figures are much higher because the ophthalmology clinics have all been closed… they probably haven’t had a chance to evaluate the new figures,” McGivney Nolan said.

“So you have conditions like glaucoma which will slowly worsen and glaucoma is irreversible, so you could have damage done with that slow and silent threatening condition. That can’t be turned around and they’re on a waiting list.

“Then you have people with cataracts, they’re getting worse. They’re losing their independence in terms of driving, they’re becoming visually impaired. Visual impairments have been shown to lead to earlier admissions to nursing homes, a risk of falls, injuries, depression, all this kind of stuff. 

So the impact in quality of life for those patients with cataracts in need of surgery is huge.

In a response to a question from Fianna Fáil TD Sean Fleming, Health Minister Simon Harris said the fall in transmission of Covid-19 in recent weeks will allow “an opportunity for increasing provision of non-covid care including more routine care” adding that private hospital capacity will “play a role” in this. 

The path to treatment and diagnosis for eye conditions usually involves an optometrist referral to a GP, with a referral then made to a hospital waiting list, a subsequent referral for a procedure, before patients then return to the waiting list for a follow-up appointment. 

McGivney Nolan suggested that allowing optometrists to play a greater role in a community care setting would alleviate the pressures on those hospital waiting lists. 

Speaking of a programme in place in the North West region of the country, she explained: “Number one, they don’t have to go through the GP, the hospital will take our referral into outpatients directly and that saves money, time and resources.

“The big difference at the moment is after they have had their surgery, when they’ve had a procedure done, their cataracts removed, you need new glasses and you need to have a check-up done to make sure everything is ok, that the eyes are healthy. 

“So you normally go back to the outpatient waiting list for a follow-up appointment… in the North West, we eliminated that and you have your surgery, the hospital rings the optometrists and they give them an appointment for their follow up and the patient is seen by the optometrist who will do the outpatient appointment that you normally had in the hospital.”

Speaking of “the new reality” caused by the pandemic, she said “we suspect things will have to change, and we will have to use optometry to help them with a lot of those lists.”

Quality of life

Fianna Fáil TD Sean Fleming said the situation for people, a large number of which are elderly patients, will “get increasingly worse” in the coming weeks and months.

“I had some elderly people who came to me over the last month or two, needing surgery and would have been willing to get it done on the cross-border initiative, or many were willing to go and pay to get it done privately in hospitals that do this,” he said. 

“But with the HSE taking private hospitals over, it has prevented them from doing that so it has come to a standstill and people who were willing to make alternative arrangements because the waiting lists are so long, are being prevented from getting the alternatives as well.

“It’s terrible to see older people so sad, these are 80-year-old people who can hardly see where they’re going. And the real sad thing is because some of them are so old, they haven’t even the heart to try and fight it.”

TheJournal.ie contacted the HSE to ask if consideration was being given to resourcing this area in order to reduce the waiting list numbers but did not receive a response.