Governments across the UK have recognised that improving eye health and preventing avoidable sight loss are public health priorities.
England
The urgent need to tackle avoidable sight loss has been recognised in the public health outcomes framework, published in January 2012. Find out more about the framework from the Department of Health website.
Wales
The Welsh Assembly voted unanimously in May 2012 in favour of a motion calling on the Welsh Government to make a measurable reduction in avoidable sight loss a public health priority.
Northern Ireland
The link between smoking and eye disease has been included in the recently published Tobacco Control Strategy. A public health strategy is due out for consultation, later in 2012. Download the strategy from the Department of Health, Social Sevices and Public Safety website.
Scotland
The Scottish Minister for Public Health launched the Scottish Vision Strategy in March and has committed to a five-year age-related macular degeneration (AMD) plan and a review of registration and certification data. Both are key areas of evidence to inform future public health strategy.
The public health outcomes framework and avoidable sight loss
"Healthy lives, healthy people: Improving outcomes and supporting transparency", the public health outcomes framework for England, has preventable sight loss as a specific indicator under domain four; "Healthcare public health and preventing premature mortality".
Find out more about the public health outcomes framework for England from the Department of Health website.
The sight loss prevention indicator evidences the levels of avoidable sight loss from glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy, which are three of the main causes of sight loss. A decrease or increase in these levels, measured through the number of Certificate of Visual Impairment (CVI) registrations attributable to these sight loss conditions, will help to give an overall indication of the eye health of the nation.
While the indicator has been adopted, further work is underway to fully define its parameters, however it provides excellent impetus for including eye health in Joint Strategic Needs Assessments (JSNAs) and to focus on sight loss prevention in local health and wellbeing strategies.
The case for prioritising eye health
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The number of people in the UK with sight loss is set to increase dramatically. It is predicted that by 2050 the number of people with sight loss in the UK will double to nearly four million.
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Evidence shows a link between people on low incomes, living in deprivation and increased risk of sight loss. Additionally, African and African-Caribbean groups have an increased risk of developing glaucoma, the Asian population has a higher risk of developing cataracts and the African, African-Caribbean and South Asian communities have an increased risk of diabetic eye conditions.
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1.5 million people in the UK have a learning disability. People with learning disabilities are ten times more likely to have serious sight problems than other people. Often their sight loss is unrecognised and untreated.
Sight loss links to other public health priorities
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Smoking increases the risk of developing age-related macular degeneration (AMD) and cataracts.
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Obesity is a risk factor for all four major causes of sight loss: AMD, diabetic retinopathy, glaucoma and cataracts.
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Visual problems are common after a stroke and can affect up to two thirds of stroke survivors. Addressing this sight loss could help improve the effectiveness of rehabilitation.
The cost of sight loss
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Health service commissioners in England spent an average of £40,900 per 1000 head of population in 2010/11.
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Sight loss costs the NHS in Wales an estimated £107 million in direct costs per annum.
Action for public health specialists
The prevalence of sight loss increases with age, and the UK population is ageing. In addition there is a growing incidence in key underlying causes of sight loss such as obesity and diabetes.
Effective primary prevention programmes tackling smoking and obesity could help reduce the incidence of avoidable sight loss in the population, meaning that public health specialists need to tackle the issue of avoidable sight loss as a matter of urgency. You can do this by:
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Incorporating eye health and sight loss prevention in public health work programmes
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Ensuring JSNAs analyse the eye health needs of the local population. Health and Wellbeing Boards will own the JSNA and will be responsible for commissioning public health services. RNIB as a UK Vision Strategy partner offers guidance for Health and Wellbeing boards on how to include eye health in JSNAs
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Including plans to address eye health and sight loss prevention in local health and wellbeing strategies. Find out more about effective eye health commissioning.
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Comparing your local authority against other authorities in the region or benchmarking your local authority against the England average by reviewing the The Public Health Outcomes Framework Data Tool. The tool presents data for available indicators at England and upper tier local authority levels, collated by the Public Health Observatories in England.
For more information about our work in preventing avoidable sight loss or how we can help better understand the role of public health in sight loss, email professionals@rnib.org.uk