There are two things you could have been doing this Sunday morning. First listening to Archers omnibus edition; will Joe Grundy get evicted? Will Ruth find out about Toby and, of course… suspense, was Helen acquitted of attempted murder of this year’s pantomime villain Rob Titchener? The second thing, which might be related, was perusing the Sunday Telegraph supplement ‘Vision matters’ an independent supplement by MediaPlanet in conjunction with National Eye Health Week.
There have been media splashes on eyes and vision before but this showed evidence of a potentially truly co-ordinated approach backed by big money from the deep pockets of the Specsavers group and the one-time service provider, now campaigning lobbyist, the RNIB.
It’s easy to be critical in these columns so I won’t be, yet. Overall the message is clear, too few people ‘get their eyes tested regularly enough’, ‘more people fear losing eyesight more than any other sense’ and that ‘regular tests can pick up eye and health conditions before people are aware of them’. It was interesting to read the survey which showed a high degree of awareness of serious eye conditions but that only one in five were aware of presbyopia which suggests at the very least the survey was among the relatively young or part of that select group who wilfully deny the onset of presbyopia. If indeed it is representative of a young dataset that bodes well for the future but it is frightening in another sense because demographically this group is the least likely to have frank eye disease or refractive error and thus not lighten the optometrist’s dark room.
I found the introduction by David Cartwright to be spot on and it was nice to see contact lenses (Brian Tompkins, BCLA president) being given a positive light and for Katrina Venerus to open up the discussion on Mecs. I was certainly prepared to gloss over the major advertising gain for the promoting group with deep pockets if the message gets across. There are banner messages about smoking and vision and obscurely on colour vision in men scattered among adverts for ‘free’ (nothing is free) and ‘discounted sight tests’ at Specsavers.
What is of a concern to me is the public barrel that the disinterested and divisive NHS has us over. There is no indication here that the GOS contract is largely looked at in derision, mostly for its low fee but in reality because of its lack of fitness for purpose. There is no indication that we are shown the revolving door at the annual fees jamboree or that the Department of Health is simply flying in the face of evidence that universality of an increased scope of GOS would be beneficial. Even the president of the Royal College of Ophthalmologists says as much. We have an ongoing dispute over the GOS, a cynical worsening of finances to the point of bankruptcy via Capita and yet in this article we pretend that the NHS sight test is practically a life-saver.
There is no indication we in the eye care sector are treated worse than junior doctors (heavily in the news) and that we struggle to match medical, GOC, College, public and perhaps even the Crown Persecution Service expectations with the limited scope of practice. Mecs and Pears are divisible if you live in cross-border areas and there is no doubt there is simply not enough time or money to do what we know we can do within the confines of the GOS.
It’s easy for a profession that promotes itself as primarily a retailer of low price optical goods to pretend publicly that all is rosy in the NHS garden. Unless or until there is a general name change to optometrist (even this supplement uses the terms optician and optometrist synonymously) and an increase in scope of practice within stores, those of us mopping up the pieces of inadequate GOS sight tests, where cataracts and early glaucoma are missed due to an inadequacy of approach, will feel aggrieved. The evidence of lack of interest in providing such a clinical enhancement is provided by the failure to charge for additional clinical examination, almost universal among the corporate sector and the lack of any private exam fee to have kept any pace with inflation since 1989.
The time is fast approaching where the standard of the basic GOS sight test threatens the livelihood and professional reputation of optometrists as people’s expectations are raised but the test can’t deliver. Without routine dilation (plugs for the Scots here), additional examination techniques, such as OCT and the widely available capability to diagnose and treat, we are condemned to be looked at as spectacle sellers who do a bit of disease checking at the same time.
So like many of us I am left to hope that such strategic investment might rub off with a few more visitors a bit more regularly and a slightly heightened awareness of the importance of eyes. Unfortunately, it won’t be long before the media is back to ‘acanthamoeba ate my cornea’ headlines. Tragic as it is, the case of missed papilloedema might have done more to raise awareness of the role of optometrists than any amount of slick advertising.
