There has been a lot of discussion recently about allowing Optometrists in Ireland to see children – to take care of their eye care needs. Optometrists are already allowed to do most things required to deal with almost all children’s visual issues, but the sticking point is that the parent either goes (for free) to a community clinic, or goes to the local Optometrist, with no funding.
Below is a repost of a Press release from the Association of Optometrists;
A detailed pdf download is available here, but the answers is clear- it would be cheaper and more convenient to have the eye test government funded at the local Optometrist – very few children really do need to be seen in a hospital, and those that may would be seen much more quickly, if all of those children who did not need to be seen were to be examined elsewhere!
Call me a cynic, but there is a vested interest in having a very long waiting list to see the Community Ophthalmologist – what parent would wait the required year or so, when the child gets a letter home from school saying there is an issue, if they could possibly scrape together the money to be be seen much more quickly privately?
I have never personally been a fan of school screenings – I have seen many who have slipped through the net, and many more who failed, who were perfectly normal.
I used to work in Cumbria, England – there, the local health authority sent a Birthday card to every child at age Three, advising them that it was time to have their first (and free until 16 under the NHS) eye test. That is the best system I can think of, and to be brutally honest….many times a school screening is too little too late…
Some of this is recollection, but my son started at the Vale School aged 5. He started to wear spectacles in senior infants, as we found him to be short sighted. I do not think he had a school screening until second class, when he would have been probably 8 years old, and already wearing spectacles for 2 – 3 years. Perhaps he was off sick for the previous screening – I do not think so, but even if he was he should have been checked another day, where they would have found that he had been unable to see very much at all far away, though they would not know that his issue had been ongoing for 2 -3 years!! After a year waiting he may have been prescribed spectacles in the community clinic in Cavan (aged now 9). It is not good enough!
The most important message I can think of at this time is that parents must realise that it it their responsibility to to look after their child’s eye care – the state is not doing anything particularly useful for you or your child!
Here is the AOI press release;
Optometrists have expressed disappointment at a HSE decision to end routine eye screening of fifth and six class primary school children without offering any alternative – and called for major reform of children’s eye-care.
Primary School Principals have been written to advising them that the HSE primary school-exit eye screening service is to be discontinued with immediate effect – saying that there is a lack of evidence to support the effectiveness of the programme.
The Association of Optometrists (AOI) said it accepted that the effectiveness of the service was questionable, but removing a major part of the Primary School Children Optical Scheme and not replacing it, or reforming it, with something better is going to make outcomes worse.
AOI said that the move will further reduce eye-care services for children which are already highly compromised by waiting lists of up to five years for non-urgent cases and six months for urgent cases.
AOI’s Optometric Advisor Lynda McGivney Nolan called for commitment from the new Government to eliminate children’s eye-care waiting lists – by moving to a community based model of eye-care, similar to what has been successfully introduced in parts of the UK.
“Children’s waiting lists can be solved quickly by referring children directly from the school scheme to their local Optometrist. Under the current system in Ireland children are referred to HSE Community Clinics, or Hospital services where there are unacceptable delays.
“All children in fifth or sixth class who notice symptoms should be entitled to go to their Optometrist for an eye examination and for follow on treatment, or referral as required.
“There are 300 Optometry locations across the country with the skills, capacity and equipment to provide responsive and clinically effective eye-care.”
AOI said it understands that there have been regional variations in response to the HSE notice and that school-exit screening is still available in some parts of the country and has been ceased in others.
“This is typical of our eye-care services where there are unequal regional variations in service agreements. This further highlights the need to reform eye-care in Ireland to ensure equality of access and quality of service irrespective of where people live,” Ms. McGivney Nolan said.
The AOI said reforming to a community based model would not only eliminate waiting lists but also save the State money and improve health outcomes for children.
“On the estimation of a HSE Community Clinic examination costing €100 per visit and an Optometrist €60 per exam (plus other additional savings), annual cost savings of millions of euro can be achieved,” Ms. McGivney Nolan said.
AOI’s full position on reform of Irish eye-care, A Community Based Model for Eye-care, can be read at www.aoi.ie.
Association of Optometrists Ireland (01) 4538850
Ronan Cavanagh, Cavanagh Communications: (086) 317 9731