“Optometrists are gatekeepers in the community”

Ophthalmologist, Nishani Amerasinghe, works as a consultant ophthalmic surgeon at Southampton University Hospitals NHS Trust, specialising in glaucoma and cataract care.

Earlier this year Amerasinghe was appointed president of the UK and Éire Glaucoma Society (UKEGS), a role that involves promoting the exchange of knowledge between glaucoma specialists who are involved in the care of glaucoma patients, as well as creating a community of scientists who can research and knowledge-share.

During her tenure, she is responsible for the organisation and delivery of an annual two-day conference that aims to provide education for glaucoma specialists in current topics and issues in the field, as well as networking and exchanging ideas.

“I also feel that my role is to help with promoting the specialty to our trainees. It is a fantastic specialty and therefore we need to nurture our trainees in glaucoma,” she told OT.

Amerasinghe explained that the UKEGS works closely with Glaucoma UK to promote the shared values of increasing glaucoma awareness, promoting research and allowing patients to live well with glaucoma.

During Glaucoma Awareness Week (24–30 June), OT spoke to Amerasinghe about raising awareness of glaucoma and the role optometrists in the community can play.

The theme of this year’s Glaucoma Awareness Week is Glaucoma in the family. In your experience as an ophthalmologist, why is this theme important?

Glaucoma in the family is a really important theme. If you have a first degree relative with glaucoma, we know that you are four times more likely to have glaucoma – this group of people do need to be tested in order to be diagnosed.

I’m always surprised at how many patients have no awareness whether they have a family history of glaucoma when I first meet them. They then come back for the next appointment and say, ‘Oh yes, my mother told me that she had glaucoma.’ In the past, these diseases weren’t really talked about, so our older population don’t know whether their parents had glaucoma. However, this is changing, and it means that people are becoming more aware of if they’ve got a family history. But then they need to take the next step and go for regular eye exams to see if they have glaucoma, and to get diagnosed early.

The Glaucoma UK awareness campaign highlights talking within your family about eye disease. I think it’s raising awareness of this and asking people to sit down and talk to relatives to find out whether they’ve got the disease so that people can prioritise their eye health, understand it’s important, and get tested.

There are lots of very good community shared care glaucoma services or community glaucoma services where optometrists review low risk patients and manage them in community

What can optometrists do to raise the profile of Glaucoma Awareness Week, but also importantly of glaucoma generally, among their patients? 

Optometrists are gatekeepers in the community; they are the people who see the general public first. They are well placed to raise awareness of eye disease and the importance of being tested to pick up early eye disease.

During Glaucoma Awareness Week, putting up posters in optometry practices, raising awareness of glaucoma, raising awareness of family history, and asking people to come in and get their eyes tested, not just for glasses, is all important. It’s getting the message out to the general public that the eye test is important to pick up eye diseases and to promote eye health.

While 1% of the UK population over the age of 40 and 10% over the age of 75 will experience glaucoma, public awareness is low. What can be done to raise the profile of this disease? 

This is frustrating. 10% of the population over the age of 75 is such a big number, yet people do not know about glaucoma – that’s why we need glaucoma awareness campaigns, Glaucoma Awareness Day, Glaucoma Awareness Week, and World Glaucoma Day – these are all really important in enabling us to get the message out there that glaucoma is prevalent, and people need to have their eyes tested.

This Glaucoma Awareness Week, we’ve done a big radio campaign to increase awareness, there are posters available and there's a lot on social media. I think it’s these ways of getting the word out there that will help us increase awareness.

It’s also important for healthcare professionals to discuss glaucoma with their patients. This is where optometrists are really well-placed to talk about eye conditions like glaucoma with the general public, to ask their patients to ask relatives about family history, or if they do have an eye condition like glaucoma to tell their family so that their family members can prioritise their eye health.

Secondary care ophthalmology has large waiting lists for services. As an ophthalmologist, how can optometrists on the High Street help?

There are lots of very good community shared care glaucoma services or community glaucoma services where optometrists review low risk patients and manage them in community, overseen by ophthalmologists with a specialist interest in glaucoma or equivalent. These services do help lighten the burden in the hospital eye service as the less risky patients can be seen in the community, allowing for more capacity for the higher risk patients to be seen in the hospital eye service.

If you had one eye care ask for the next Government, what would it be and why?

It would be prioritising eye health. Glaucoma has a high incidence in the population, and if it is not picked up early, not only is it a burden on the hospital eye service treating advanced glaucoma, but it’s also a burden on social care as these patients require social services to support them. By prioritising eye care on the health and social care agenda, we will save patients from long term visual loss. The morbidity from this will save governments money in the long term, by not having to pay for both complex health services and social care.