A dramatic increase in the number of local services supporting older people who are blind or partially sighted as the UK’s population rapidly ages is needed according to the Local Optical Committee Support (LOCSU).
It warns that without more specialist local services, the growth in numbers of older people with eye health problems will lead to more falls, isolation and depression, with these problems particularly severe around the winter period.
One in five people aged 75 and over are blind or partially sighted, and the UK’s eye health problems are likely to increase as the population ages. It is predicted that by 2020 over 750,000 people will live with age-related sight loss: an increase of nearly 150,000 since 2010.
The consequences of sight loss can be devastating for older people:
• Falls are most common in older people with sight loss: an estimated 25,000 hip fractures a year are in patients who are visually impaired, with falls most likely during icy conditions;
• Isolation: up to 50% of older adults with poor vision say they restrict their activities because they feel unsafe, with loneliness particularly acute around winter;
• Depression: sight loss is one of the top three causes of suicide among older people.
Just 34 out of 211 Clinical Commissioning Groups, which are responsible for funding local health services, provide community-based specialist eye health services for older people with sight loss. LOCSU has called for more areas to provide local services to support older people with low vision, and reduce the numbers of people who face problems that need to be treated in hospital.
These local services allow older people with sight loss to be supported by high street optical practices, which have specialist equipment, and clinical staff who can provide aids like magnifying glasses to help older people get the most of their remaining vision and so stay in their own homes safely. The services provide a follow-up visit to check how well the patient is using the aids, and whether any emotional support is needed.
When these services are not provided in the community, older people who are blind or partially sighted often have to travel to out-of-town hospitals to see a specialist. According to LOCSU, these hospital-based services are often difficult for patients with sight loss to attend, particularly older people who are more likely to live alone. Hospital services are also often more expensive for the NHS.
Without an increase in the number of these services, the NHS will struggle to meet the eye health needs of the ageing population, say LOCSU. This is predicted to have wider consequences for the health service, as people who are not helped to adapt to sight loss are more likely to suffer falls and isolation-related mental health problems.
Katrina Venerus, Managing Director of LOCSU, said: “Problems relating to sight loss exist year-round but are particularly severe around winter when older people can feel more isolated, particularly those that live on their own; and the ground is icy so falls are more common.
“We cannot keep relying on hospitals to meet these everyday needs. As more people face sight loss related to ageing, we have to find the best ways of providing services to help them continue to be active and independent. For most people, services are more accessible when they are located in their community – not in an out-of-town hospital. They need a range of integrated community services, including emotional and social support to help them continue to live independent active lives.
“The potential benefits are enormous. If we improve how we deal with low vision among older people, we will improve the lives of many people who would otherwise have been restricted by sight loss. We will also save money for the NHS, as we will reduce the direct pressures on hospital eye departments and the indirect costs from vision-related problems like falls and fractures.”
Regular sight tests are also needed to identify conditions that can lead to sight loss, including age-related macular degeneration and cataracts, as well as out-of-date prescriptions, say LOCSU. These tests can benefit everyone, but are particularly important for older people.