Milestone moment as 101 patients receive sight loss certification in primary care

Optometrists in Wales have issued Certificates of Vision Impairment (CVI) to 101 patients with bilateral atrophic age-related macular degeneration (aAMD) since May 2023.

The task, which was previously carried out by ophthalmologists working in hospital, has been extended to optometrists with relevant qualifications under the Wales General Ophthalmic Services contract.

Certifications carried out by domiciliary and High Street optometrists over the year account for 29% of all certifications for aAMD over the period in Wales.

The introduction of the changes followed research that showed agreement between ophthalmologists and optometrists in identification of eligible patients for CVI.

Of the 101 certifications that were performed over the period, around one in five (18%) were performed as a mobile assessment in the patient’s own home.

Domiciliary optometrist, Lisa Evans, shared that being able to certify patients who are housebound has been a “positive step.”

“Many of my patients had made the decision previously that the visit to the hospital for certification would be too much and had declined a referral,” she said.

Evans shared that certification had given some people validation while also resulting in financial improvements – such as a reduction in the TV licence fee and the blind person’s tax allowance.

“Importantly they feel they are not forgotten in what can be an isolating environment. It saves many people the stress of ambulance transfers and the physical and mental strain this may cause. We have the knowledge and time to spend with our patients in the comfort of their own home, and it’s lovely to use our skills to help our patients,” she said.

Wales Council of the Blind director, Owen Williams, shared that he is “delighted” people with bilateral aAMD have been able to receive CVI on the High Street or in their own home.

“Thanks to an accompanying leaflet, these patients have had faster access to additional support, welfare benefits, financial concessions and services in social care,” he said.

Wales General Ophthalmic Services national clinical lead, Rebecca John, shared her expectation that the number of certifications performed in primary care will continue to grow.

“NHS Wales will continue to further develop the certification pathway, with the potential of extending to other causes of vision impairment in the future,” she said.

Chief optometric adviser for Wales, David O’Sullivan, OBE, shared that it was pleasing to see people accessing eye care services quicker and closer to – or even in – their own homes.

“The Certificates of Vision Impairment have been invaluable to those that need it the most, and this is just one of the pathways that had positively impacted the optometry sector in improving patient care and reducing waiting times for specialist eye care services,” he said.