Glaucoma patients left to go blind due to delays for NHS appointments

NHS patients are being left to go BLIND because of year-long delays in getting appointments for glaucoma and other vision-robbing conditions, damning report warns

• Probe finds lengthy delays at NHS eye services caused by severe lack of staff
• Healthcare Safety Investigation Branch predicts 22 people a month go blind
• Investigation launched after mother-of-three went blind after year of delays 

Glaucoma patients are being left to go blind on the NHS due to lengthy delays for appointments, a damning report has found. 

The Healthcare Safety Investigation Branch (HSIB) estimates 22 people will fully or partially lose their sight each month as a result of the delays in England.

The watchdog, which probes serious medical errors, found NHS sight services were becoming increasingly strained due to a growing number of patients. 

It said some clinics were relying on under-qualified and temporary staff, as well as trainees, to try and cope with soaring demand. 

The HSIB launched an investigation after an unidentified 34-year-old mother went blind as a result of 13 months of delays to follow-up appointments for glaucoma. 

Glaucoma, which leaves one in 10 of suffers completely blind, is caused by the death of retina cells at the back of the eye. 

It is most common in the elderly and is becoming more prevalent as the population ages. Around half a million patients in England have glaucoma.  

Glaucoma patients are being left to go blind due to lengthy delays for eye appointments on the NHS, a damning report has found (file) 

The mother was left unable to properly care for her children, confined to her home, and her husband was forced to slash his hours at work to look after their family.

The HSIB report said the woman had first visited a high street optician in June 2016 after noticing that her vision was getting worse.

She was diagnosed with glaucoma and referred to the local hospital eye service (HES) for an urgent assessment.

But lack of staff, delays to appointments and ‘missed opportunities’ over a 13-month period led to her sight deteriorating further. 

The report said her plight was made worse by the fact that she was seen by trainees who did not always escalate the seriousness of her condition.  

The trust which treated her, which was not named, admitted it couldn’t offer appointments in a timely manner to its 4,500 ophthalmology patients.

Glaucoma is a condition which can affect sight, usually due to build up of pressure within the eye.

It often affects both eyes, usually to varying degrees. One eye may develop glaucoma quicker than the other.

The eyeball contains a fluid called aqueous humour which is constantly produced by the eye, with any excess drained though tubes.

Glaucoma develops when the fluid cannot drain properly and pressure builds up, known as the intraocular pressure.

This can damage the optic nerve (which connects the eye to the brain) and the nerve fibres from the retina (the light-sensitive nerve tissue that lines the back of the eye).

In England and Wales, it’s estimated more than 500,000 people have glaucoma but many more people may not know they have the condition.

Worldwide, it is the second leading cause of blindness, according to the World Health Organisation.

Glaucoma can be treated with eye drops, laser treatment or surgery. But early diagnosis is important because any damage to the eyes cannot be reversed. Treatment aims to control the condition and minimise future damage.

If left untreated, glaucoma can cause visual impairment. But if it’s diagnosed and treated early enough, further damage to vision can be prevented.

Source: NHS Choices 

The HSIB report said: ‘Following a review of the patient’s care, it was agreed there had been missed opportunities to preserve her already limited sight, and that this had left her significantly disabled and unable to lead a normal life.

‘The patient’s current consultant confirmed that, in her opinion, the patient’s disease progression would have been prevented had she been seen and treated in a timely way.’

The woman was eventually registered as severely sight impaired. The HSIB said a lack of timely follow-up for glaucoma patients is a recognised national issue across the NHS.

Keith Conradi, HSIB’s chief investigator, said: ‘Glaucoma is the world’s leading cause of irreversible blindness.

‘We know that the delay to appointments once patients are diagnosed exacerbates the risk of sight loss in patients across England.

‘Our patient has suffered immeasurably, living with the effects each day, including not being able to see the faces of her young children or read books to them.

‘Despite some national recommendations being made 10 years ago, this continues to happen and will only worsen as the population ages.’

He added that it is estimated there will be a 44 per cent increase in the number of people with glaucoma by the year 2035.

Mr Conradi claimed research shows that around 22 patients per month suffer severe or permanent sight loss as a result of delays.

The investigation found inadequate national hospital eye service capacity to meet demand for glaucoma services, and recommended better ways of working.

It said its findings related to glaucoma patients but are ‘likely to be applicable to follow-up of patients with other eye conditions’.

Mike Burdon, president of the Royal College of Ophthalmologists, said: ‘We have been campaigning for some time on how the delays to follow-up appointments results in the loss of vision for patients.

‘The HSIB report and the recommendations are extremely welcomed and must not be overlooked.

‘With demand for ophthalmic services predicted to rise by more than 40 per cent over the next 20 years, urgent action is needed.

‘We look forward to working with NHS England and other key stakeholders to the transformation of ophthalmic services to safeguard the sight of patients.’ 

Helen Lee, policy and campaigns manager at the Royal National Institute of Blind People (RNIB), said: ‘This report has brought vital attention to a serious and dangerous lack of specialist staff and space in NHS ophthalmology services across the country.

‘We know that thousands of patients in England are experiencing delays in time-critical eye care appointments, which is leading to irreversible sight loss for some, but suggestions on how to tackle the problem have been continually ignored.

‘Without immediate action, the situation will only continue to deteriorate as the demand for appointments increases.’ 

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