OFNC Statement on meeting essential eye care needs during the pandemic

27 May 2020

The definition of essential eye care in NHS England’s letter of 1 April is:

“this includes but is not limited to appointments for patients who would not normally be considered to be emergencies, but where, in the practitioner’s professional judgement, a delay in an examination may be detrimental to a patient’s sight or wellbeing. This may include where patients have broken or lost their glasses or contact lenses and need a replacement pair to function.”

This enables practitioners to exercise their professional judgement to determine whether a particular patient need falls under the heading of essential care.

As the pandemic has progressed and scheduled primary eye care services have remained suspended, inevitably there is now an expanded range of situations where individual patient needs are now likely to be essential.

Examples include:

• Patients who require an appointment due to clinical risk factors that are being monitored by the clinician. While in the initial stages of the pandemic deferring these appointments was acceptably low risk and justified when balanced against the risks of providing face-to-face care, the passage of time since the last examination may now have increased the risk to the point where the patient’s needs now fall within the definition of essential care.
• Patients with a minor reduction in vision, and patients with broken spectacles that have been “making do” with older spectacles with an out-of-date prescription. In the initial stages of the pandemic, these patients may not have met the definition of essential eye care because their condition was not having a material effect on their sight or wellbeing. As lockdown conditions are starting to ease and patients are likely to undertake more vision-dependent tasks, such as working and driving, it is likely that more of these patients have needs which fall within the definition of essential care.
• Patients who are anxious or concerned about their vision, in the absence of clear clinical indications. Some patients may be particularly susceptible to the effects of pandemic and lockdown on their wellbeing. This may lead to them developing mental health problems or exacerbating existing mental health problems. As such these patients’ need may now meet the definition of essential care.

All patients should be considered on a case by case basis by the appropriate clinician, using remote triage in the first instance, to determine whether in their professional judgement the patient requires a face to face appointment.