Optometry management of acute eye care in Wales

Schemes for the optometric management of acute eye disease in Wales have been running since 2001, with the Primary Eyecare Acute Referral Service (PEARS) scheme in the Bro Taf health authority area being the first. This was helped along by devolution and the transfer of health care powers to the Welsh Assembly, and also by the small scale of Welsh health authorities at the time. Prior to the introduction of the service, the frontline for acute eye care in Wales involved general practitioners. It has been reported that approximately 2% of GP consultations are eye related,¹ and these consultations are largely conducted by the use of history taking and examination with non-specialist equipment. It has also been noted that, in the main, GPs receive inadequate ophthalmology training.² The aims of the initial service were to reduce unnecessary referrals to secondary care, provide good quality care close to home, to improve the accuracy of referrals and to improve relationships within primary care and between primary and secondary care. The initial scheme proved successful with a reported 76% reduction in the number of acute referrals.³ This led to the scheme being rolled out across Wales in 2003.