OPTOMETRISTS HAVE CALLED for an end to the “geographical lottery” in children’s eye-care, as well as the establishment of a national public programme for children aged over eight.

It follows research which has revealed “significant geographical inequality and gaps” in access to children’s eye-care across the country.

Optometry Ireland (OI) is the professional representative body for the majority of practising optometrists in Ireland, with 700 members in 350 locations nationwide.

It emailed HSE Community Healthcare Organisations (CHO) to “request clarification on the over 8’s policy in their area”.

The OI said that “only some responded, while others declined to reply”.

The OI research is based on “CHOs that responded and from surveying the experiences of Optometry Ireland members in each CHO”.

Their research revealed that there is no public eye-care scheme in place for children aged over eight in HSE CHO Areas 1 or 6.

CHO Area 1 covers the Northwest and includes counties Cavan, Donegal, Leitrim, and Monaghan while Area 6 covers Wicklow, Dun Laoghaire and Dublin South East.

There are also discrepancies in cost, with some parents accessing a service at an optometrist paying a top up fee of €22.51, while in other areas parents pay a full fee which can range from €30 upwards.

Meanwhile, children requiring complex glasses are entitled to €150 towards these glasses in some areas, while other areas have no voucher scheme in place, or offer a voucher to a maximum of €51.

Optometry Ireland CEO Sean McCrave said the “ongoing gap in the provision on children’s eye-care, particularly for 8-16 year olds for whom there is no national eye-care scheme, needs to be addressed urgently”.

He added that efforts in addressing these geographical gaps has been “very slow, minimal, and piecemeal”.

McCrave called on the Health Minister Stephen Donnelly to intervene, adding: “We want to sit down with the HSE and together implement a consistent and equitable scheme, with protocols and clarity in all regions.

“Resourcing the needs of over 8 children, via a public agreement with optometrists, would also free up resources in hospitals and HSE clinics for adult eye-care to help address very lengthy waiting times.”

School screening

Public eye-care in Ireland starts with a school screening involving every child aged between five and six undergoing a vision screening.

However, McCrave said this programme is “highly variable” and added: “Many children missed the school screening due to COVID, meaning there is currently a significant cohort of school children who are at risk of visual impairment due to not having been screened for vision deficits.”

He further explained that children identified in the school screening programme are then divided into the under 8s and over 8s.

“While some under 8s continue to receive access to specialist ophthalmic care, the large majority of over 8s, who have been prescribed glasses and their visual system has stabilised, are then discharged from being within the HSE service,” said McCrave.

“In order to address this, some of the CHOs have introduced an ‘Over-8’s community ophthalmic scheme’, whereby the children are discharged to local optometrists.

“However, the method of delivery is highly variable by region. The level of care, and what is covered by the HSE, depends entirely on where the child lives – thus access to over 8 children’s eye-care is inequitable and a postcode lottery.”

The Optometry Ireland CEO said there is a “clear gap in services and Ireland needs an agreed universal national eye-care programme for children aged 8-16”.

“An 8-16 year old’s programme should be provided by the resources of optometrists working in the community under a standardised agreement with the HSE.

“Both the HSE and numerous Ministers for Health have acknowledged this gap and the HSE has years ago said it was committed to addressing it.

“There is still no national coordination of a policy, and in no part of the country is there a formal agreement on a defined public eye-care scheme for 8-16 year old children, or any contract in place with optometry.”