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Optos founder Douglas Anderson has described the take-up of the Optomap system as slow in the UK because unlike the US it is not viewed as part of a routine eye check.

In an interview in The Times (April 9), he pointed out that US primary care OOs do a four-year postgraduate degree, as opposed to three years as an undergraduate in the UK.

Six years after Optomap was launched, only 80 are in use in the UK compared to around 3,000 in the US, despite its obvious benefits, he said.

While in the US there was a 'pretty straightforward referral process to the next level of care if something is detected' the UK was 'diabolically protracted'. 'There's often a lack of respect from the ophthalmologists in secondary care to those in primary care. So there's nervousness on the part of some practitioners who are trying to improve their clinical performance, and a lot won't make the clinical decision. They just refer. The consequence is that 60 per cent of the referrals into the NHS are unnecessary, and if you consider the average waiting time for an ophthalmologist in the UK is 22 weeks, a lot can happen in that time,' he said.

'A tumour can communicate itself to the brain in that time. Retinal detachments go from being treatable to untreatable. If you take the 60 per cent out of the waiting list you immediately drop to seven weeks, though even that's not acceptable. And if you were doing proper examinations and you were competent diagnostically you would not only pull out the 60 per cent but you'll put in an extra 5 to 6 per cent that really need to be seen. You would pick up on systemic disease as well as eye disease - but up to now some practitioners have considered that's not their business.'

Anderson concedes that take-up of Optomap has also been partly hindered by the NHS and its low remuneration.

Optomap user Kevin Lewis, president of the College of Optometrists, said that around 50-60 per cent of his patients were happy to pay the extra £25 charge, which means the machine pays for itself. Take-up is hindered because there isn't a culture for charging for examinations in the UK.

A College spokeswoman told Optician that optometry in the US and the UK were developed along quite different lines, which may explain some of the difference in take-up of technologies such as the Optomap. She added that the vast majority of UK optometrists have taken a first degree in optometry followed by a pre-reg period of training under supervision. 'In this way, most will have undertaken around four years' training in total before they are eligible to register as an optometrist.'

She played down claims that the average waiting time for an ophthalmologist was 22 weeks and pointed out that the target in the UK was no longer than 13 weeks for the first outpatient appointment. Urgent referrals are seen according to need - often within a few days.

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