In a collaborative project, data from 2019 were compared with those from 2020, to determine the reduction in patient care due to the coronavirus pandemic.  The study, held in November 2020, found that the number of referrals for glaucoma fell dramatically in 2020, in addition to a reduction in surgeries and outpatient appointments. The research, which was pro- bono work produced by HSJ Information Ltd (formerly Wilmington Healthcare) and featured data from NHS Digital and  Specsavers.

According to data from both NHS Digital and Specsavers, the number of referrals from optometry into hospitals for glaucoma had been reduced by around 70% in 2020 compared to 2019. There was also a noticeable reduction in surgery, with trabeculectomies falling by 47% and MIGS procedures by 42%. Glaucoma UK confirmed that the reduction in trabeculectomies was particularly concerning. The charity stated that the backlog will need to be addressed, which will create more delays and could mean a patient’s vision may have deteriorated further before they receive the treatment they need.

The research also found that face-to-face appointments fell by 54% in the period from March to August 2020, with tele-appointments increasing by 489%. Glaucoma UK confirmed that despite the rise in tele-appointments providing reassurance that ophthalmologists were checking-in remotely with high-risk patients, this kind of interaction cannot replace face-to face appointments. The charity stated that it is important for tests such as pressure and visual fields to still be undertaken in person as deterioration is asymptomatic for patients with glaucoma.

Glaucoma UK and HSJ Information Ltd concluded their findings with an action plan to mitigate the impact of Covid-19. This includes implementing a risk stratification process to identify priority patients, making sure systems are in place to clear the backlog and ensuring electronic patient records are accessible across all sectors. These actions will coincide with keeping patients informed of their risk level and what it means for their care.

Sue Thomas of HSJ Information Ltd said “The value of data like Hospital Episode Statistics should not be underestimated as it can provide very valuable insight into how services are performing and the impact this might have on people with Glaucoma. This data provides crucial evidence that immediate action is needed to address the current backlog and reset and reform glaucoma services.

It is obvious that services will need to change to manage the numbers of people with glaucoma. We hope this information will provide an impetus for service transformation.”

Glaucoma UK’s Head of Support Services Joanna Bradley, who worked with HSJ Information Ltd on the project, said “We would like to thank Wilmington Healthcare for undertaking this project, and Specsavers for providing us with their data. Although the figures look quite scary, there is lots that can be done, as shown in our action plan. Many of these ideas have been talked about for some time, and the hope is that the massive changes brought about by Covid-19 will give impetus to their development and drastically improve services. Although the pandemic has been devastating for anyone personally affected and for society as a whole, we hope that eye care services will emerge in a better position and better able to prevent glaucoma sight loss.”