AMD campaign voiced in the House of Commons

Optometrists can help thousands of AMD sufferers through referrals, a Westminster meeting was told this week

Professionals must refer AMD patients immediately and directly to retinal specialists to cut the estimated 3,000 sufferers who are missing out on treatment and losing their sight each year.

This was the message at this week's House of Commons briefing, presented to MPs by eye health charities the Macular Disease Society (MDS) and Royal National Institute of the Blind (RNIB).

Despite two-year-old National Institute of Clinical Excellence guidance recommending fast track referral for patients with wet-AMD, sufferers are still being delayed with some waiting up to six months for treatment, the charities have claimed.

Jonathan Shaw, Labour MP for Chatham and Aylesford, opened the meeting in the members' dining room on Tuesday (November 15) and introduced guest speakers Tom Bremridge, CEO of the MDS and Steve Winyard, director of public policy at the RNIB and Chair for the UK AMD Alliance.

Bremridge accused the National Health Service, specifically optometrists and doctors, of failing patients by referring them back and forth to the wrong places, delaying their treatment and risking their sight.

Referring to the rapid onset of wet-AMD as 'bleed to bust in three months', he said referrals to a retinal clinic should take no longer than three weeks.

'By the age of 75, one in five people may be affected by AMD,' he said. 'Each year, 7,500 diagnoses are made, yet 3,000 are not being referred to a retinal specialist centre quickly enough. It is deplorable because once the sight is lost, it won't come back.

'Patients lose their central vision and they can't read, drive or even recognise their friends on the street. They are disabled, isolated and suffer considerable emotional stress as a direct result of a condition that could have been caught in time,' he added.

Until legislation is in place to allow optometrists working within GOS to directly refer patients, he urged optometrists to work together with ophthalmologists in their area to agree a referral system with their nearest hospital.

Bremridge said that it was optometrists' professional duty to refer and in doing so their practice would be well regarded in the community for providing a full service.

'Every practice should have one staff member who knows about macular degeneration. There should be leaflets available telling patients about the disease and optometrists shouldn't be afraid to make a diagnosis and refer their patients,' he said.

He also raised the possibility of whether optometrists should be remunerated for dilating the pupils to have 'a better look at the back of the eye'.

'Some ophthalmologists would deem this a waste of time, while others would argue that it is important to recognise additional skills,' he said. 'Any poor relations between optometrists and ophthalmologists must be broken down.'

Winyard pointed out that in certain areas the referral process was working very effectively and that we should learn from these examples.

'In Thames Valley, ophthalmologists were getting tired of the slow referral process and now operate a direct fax system with the Oxford Eye Hospital to ensure patients are seen,' he said.

In his speech on the effects of smoking, he said that increased understanding of the causes and treatments of wet and dry AMD over the past 10 years, made it crucial to take action.

'There are 18,000 smokers in each constituency and we now know that smokers are two to four times more likely to develop AMD.'
Pointing to the example of anti-smoking campaigns in Australia, he said that the threat of losing sight had proved very effective in making people quit.

'It is predicted that up to 69 per cent of smokers in the UK would quit if they knew its link to sight loss and we want this message to be an integral part of the DoH anti-smoking campaign,' he said.
emma.c.white@rbi.co.uk