There has been understandable consternation following the release of guidance for CCGs outlining conditions for which over the counter items should not routinely be prescribed in primary care.
It addresses a wide range of conditions, including dry eye disease, for which the document states; ‘a prescription for treatment of dry or sore eyes should not routinely be offered in primary care as the condition is appropriate for self-care’.
While we concur with the principle of NHS England trying to save money on non-essential items, there is a concern that no exceptions are allowed for dry eye treatment.
Dry eye covers a very wide range of severity and, in the most extreme cases, can cause blindness. There is a link between dry eye and depression and in terms of quality adjusted life years, severe dry eye is on a par with angina and dialysis. To claim, therefore, that dry eye treatment is ‘non-essential’ is potentially a crippling blow for some long-suffering patients.
The work done as part of TFOS DEWS II, an international collaboration to work on the very latest definition of dry eye, appears not have to been looked at, let alone been taken into consideration.
We have major concerns over this recommendation which appears, at best, a serious error of judgement.
Public awareness of dry eye is growing but there is still more to be done in this area. The BCLA has recently launched a full dry eye certificate and, with more than 200 eye care professionals already signed up to the programme, there is hope that patients will be able to find a dry eye accredited practitioner near them very soon.
We can only hope that policy makers elsewhere wake up to the problem and rethink this guidance.