Last week Boots Opticians launched a green paper demanding action to improve children’s eye health.
It stressed the impact of poor vision on education, literacy and engagement in sport. The paper follows research findings by the College of Optometrists showing the prevalence of childhood myopia has doubled since the 1960s.
Despite all this, a quarter of children have never had an eye test and school vision screening continued to be blighted by what the multiple described as a postcode lottery.
The green paper, entitled Seeing the Future, has been directed at parliamentarians, policy-makers and commissioners. It calls for better parent education, training for teaching staff and engagement with school governors.
Meanwhile, the paper also called for mandatory commissioning of a fully funded vision programme for children aged four to five.
In addition, changes to the current NHS voucher system were needed to enable children and young people to access a fuller range of vision correction, including additional pairs where clinically necessary, contact lenses and sports eyewear.
Movement of secondary care services into the community and more training in practices was also cited by the multiple.
Ben Fletcher, managing director of Boots Opticians, told Optician the green paper had been eight months in the making as part of a wider children’s eye health programme.
He said: ‘We saw an opportunity to step in and say, first of all, let’s bring together all of the knowledge in one place, and, secondly, with that knowledge let’s find sensible solutions to propose to a broad array of people.
‘What we wanted and have managed to do is have a lot of interactions with interested individuals, academics and bodies within the industry. So when we got to the point of publication last week we’d already started very constructive dialogues with them.’
An initial launch to optical bodies, local authorities, charities and MPs took place at Church House, Westminster Abbey, last week.
‘What I hope this does is provide an opportunity for all of the interested parties to coalesce around this.
‘I hope it serves as an education. When we think about awareness we often think about parents and carers, but what this really does is raise awareness of the issue amongst the industry, policy makers, commissioners. And in raising awareness it serves as a call to action,’ added Fletcher.
He suggested work at the local level, with LOCs, councils and industry bodies.
Fletcher said: ‘Sometimes we try to solve these problems at national level and say “well until we get the whole thing nailed down nationally we can’t do anything”. But one of the things that we really debated at the launch and there was a lot of appetite for was what can we do in location A, B or C.
‘We have some strong relationships across some very key academy trust chains. The advantage of that is you can go and have one conversation at an academy trust level that reaches 20 odd schools. I think there are a lot of interested people who can make a difference.
‘One of the recommendations we have made is for an orthoptist led screening programme. We know that is present in about half of the country’s schools but we are recommending it be present in the other half.
‘What we have tried to do in particular is bring to life what the impact of living with an undiagnosed sight issue might be. In truth there are very cost-effective solutions. Running a screening programme is not hugely expensive, but having a child who grows into an adult living with an undiagnosed issue is.’
He called for education through the Red Book, where there is ‘next to nothing’ on vision, and said Boots was locked in negotiations with a few local authorities for possible amends to be made.
Fletcher added: ‘There is nothing there for parents at that early stage and they might then assume it happens at the school but never ask. A lot of assumptions then go forward that have a big impact.
‘Our recommendations say that a screening programme must be in place but that in itself is not enough. It will really help but it’s not enough.’
The children’s vision green paper comes at a particularly sensitive time.
Earlier this year saw the conviction of locum optometrist Honey Rose for manslaughter by gross negligence after the death of eight-year-old patient Vincent Barker in 2012. She was sentenced to a two-year prison term, suspended for two years (Optician 26.08.16)
Rose had been locuming at a Boots Opticians in Ipswich when the patient attended a routine eye test, but she failed to detect swollen optic discs and he later died from a build-up of fluid on his brain.
Boots had already started the work on its green paper and wider children’s eye health programme before the trial began.
Fletcher added: ‘What it [the trial] did for us was redouble our determination to make a difference. What the case evidenced was how important it is to get eyes tested.
‘It’s a real credit to Vincent’s parents that one of the things they spoke so explicitly about after the court case was that they did not want anyone to be put off having an eye test as a result of the case. All through that case our thoughts are with the Barker family.’
The green paper estimated that 1.5 million school children had an undiagnosed vision problem in England alone.
Currently, the system was deemed to be over-reliant on the understanding of parents about the importance of regular eye exams – something many still aren’t keeping to themselves. The effect of neglecting eye care at an early age could have longer term impacts such as unemployment as a result of literacy problems or obesity from being unable to participate in sports.
The paper, compiled with the help of experts including Professor Maggie Woodhouse of Cardiff University, presented facts from across a range of sources. It said one in 30-50 children would develop amblyopia, while myopia affected one in three. Children with a parent who has myopia were three times as likely to be affected, and spending 40 minutes a day outside over three years could reduce the incidence and progression of short-sightedness.
The impact of poor eye health was also assessed – with Boots finding 80 per cent of what children learn is through sight, while in some children vision correction had been found to improve learning and behaviour.
Other research, into demographics, highlighted inequalities in the eye health of people from lower socioeconomic groups, based on research carried out in Leeds and Norfolk. ‘People from lower socioeconomic groups can be disproportionately affected by barriers such as a lack of education or isolation from the local community. This can contribute to a lack of awareness of the importance of eye health across families, and further barriers to accessing eye care services,’ the green paper noted.
More immediately, Boots is concentrating on its ‘Schools Challenge’, calling on staff to spend two days a year helping children through reading activities and educating them about the importance of their eyes. It will also continue a partnership with the National Literacy Trust.
Fletcher added that the wider optical sector would need to approach children’s vision in a more joined up way to make a real impact.
He said: ‘The spirit which underpins it is very definitely one of partnership. We don’t think we can do it all and we don’t think any other one organisation can do it all.
‘We think it’s really important that if we all see the issue in the same way, we ask what can each group contribute to make the situation better?’