Title: Eye health care in Wales: Increasing awareness of eye health and primary eye health care to people from at risk Black and Minority Ethnic communities.

Author: Siân Biddyr, Dr Nik Sheen, Dr Bablin Molik, Peter Garwood, Dr Siân Griffiths, Dr Tom PorterPublisher: RNIB Cymru; Year of Publication: 2016


Research shows that one in 10 people from BME communities over the age of 65 will experience serious sight loss [1]. Asian and Black ethnic groups are at greater risk of eye diseases (such as glaucoma and diabetic retinopathy) compared to other ethnic groups and are more likely to go blind [1-3]. Asian and Black communities in the UK are less likely to attend primary eye care appointments despite the increased risk of sight loss [4,5]. In Wales, a free eye health examination called Eye Health Examination Wales (EHEW) exists for Black and Asian ethnic groups, funded by Welsh Government, but this service has been underused.


The aim of the project was to increase public awareness of eye health and the free eye health care available to people from Black and Minority Ethnic (BME) communities in South Cardiff. This included, increasing awareness of Eye Health Examination Wales (EHEW), an extended eye examination funded by Welsh Government, available for at risk groups, and eye health and eye disease. Additionally, to determine if increased awareness in BME communities resulted in an increase in service use and to explore the barriers to accessing primary eye care services amongst the study population.

The results of the project are intended to inform best practice of ways to engage with specific Asian and Black communities on eye health and to understand the barriers to attendance at primary eye care for these communities.

The project was commissioned and given some initial funding by Public Health Wales. It was project managed by RNIB Cymru and implemented and further resourced by RNIB Cymru, Sight Cymru, the Eye Health Examination Wales Clinical lead at Cardiff University School of Optometry and Vision Sciences and the Optometric Lead in Public Health Wales, over a six month period. Following the intervention, data was collected and analysed to evaluate the project and this took place over a period of 12 months.

Key findings:

Awareness talks were delivered to different groups and key eye health messages given out via community activities, to approximately 1,800 people during six months, leading to an increase of 29% more people from BME communities accessing eye health examinations in the project area.

The evaluation results from the project suggest that the approach was successful in raising awareness of eye health in the communities targeted. This was demonstrated by:

  • Participants in the focus groups reporting an increased awareness of eye health as a result of attending community activities where eye health messages had been given out, and
  • An increase in the number of people from BME communities having EHEW eye examinations at optometry practices in the project area and in Cardiff and Vale University Health Board.

The project has drawn attention to a number of issues BME community groups face in accessing primary health care optometry services. Endorsed by Welsh Government, the previous Chief Optometric Advisor and the Health Minister, and shared with partners and members of the Welsh Government Eye Care Delivery Plan group, the recommendations are being used to influence eye care policy.


1. Scase MO, & Johnson MR. Visual impairment in ethnic minorities in the UK. In International Congress Series 2005:1282; 438-442.

2. Access Economics Pty Limited (on behalf of RNIB). Future sight loss UK(1): the economic impact of partial sight and blindness in the UK adult population 2009.

3. Elam AR, & Lee PP. High-risk populations for vision loss and eye care underutilization: A review of the literature and ideas on moving forward. Survey of ophthalmology 2013; 58(4): 348-358.

4. Leamon H, Hayden C, Lee H, Trudinger D, Appelbee E, Hurrell DL, Richardson I. Improving access to optometry services for people at risk of preventing sight loss: a qualitative study in five UK locations. J Public Health 2014; 36 (4): 667–673.

5. Patel D, Baker H, Murdoch I. Barriers to uptake of eye care services by the Indian population living in Ealing 2006, West London Health Educ J, 65 (3) (), pp. 267–276