ArticleOphthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)2025
Hospital to community in Wales: What is the value of optometrists playing a greater role in managing neovascular AMD and glaucoma in primary care?
Article in Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Patient-reported experiences and patient-reported experience measures in primary care, home care, and community settings. A scoping review.Frontiers in rehabilitation sciences · 2026Pooled it
- Support for Older People With Vision Impairment: A Rapid Realist Review.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026Review
- Integrated management of dry eye-depression comorbidity: mechanistic insights and temporal therapeutic strategies.Frontiers in medicine · 2026Article
- Rural Eye Care Access, Workforce Challenges and Opportunities: Perspectives of the Eye Health Workforce in Western Australia.The Australian journal of rural health · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
purposeTo evaluate the value of enhanced optometric services for managing neovascular age-related macular degeneration (nAMD) and glaucoma in primary care optometry services, instead of hospital eye services (HES).
methodsSeven enhanced optometric service pathways in primary care in Wales were assessed with a mixed-methods approach: three for nAMD and four for glaucoma. The methods were a patient-related experience measure (PREM), a Realist Review and Evaluation involving both patients and staff, a discrete event simulation model estimating the economic impact of the pathways and a workforce survey of optometrists to gauge capability and capacity.
resultsPatient-related experience measure responses (802) indicated that primary care experience was comparable to that of HES. Utilising enhanced optometric services in primary care resulted in reduced wait times compared with HES, with suspected nAMD shortened to 4-5 days and glaucoma monitoring to 5 days. Waiting lists were dramatically reduced with primary care-based services to just three people waiting for nAMD and five for glaucoma, compared with 216 and 5691 people, respectively, in HES. Consultant ophthalmologist time was reduced from 57% to 15%-16% for nAMD services and from 48% to 22%-23% for glaucoma services. Integrating enhanced optometric services into primary care incurred a similar cost. The workforce survey confirms that optometrists possess the skills and qualifications and are willing to deliver these enhanced optometric services. The Realist Review and Evaluation revealed that clear patient communication, effective coordination and strong interprofessional communication between optometrists and ophthalmologists along with a shared electronic record are crucial to the success of this change.
conclusionProviding enhanced optometric services in primary care for nAMD and glaucoma brings substantial benefits for the UK National Health Service and patients, including reduced waiting times, waiting lists and released HES capacity. The success of this transition hinges on clear patient communication, administrative co-ordination and effective interprofessional communication.
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