Can you imagine coming to terms with losing your eyesight? As a society, we are more scared of losing our sight than developing Alzheimer’s, or Parkinson’s, or having to use a wheelchair.
At the London Assembly Health Committee we have been investigating the state of eye health in the capital. It’s not a pretty picture. By 2030 194,000 more Londoners are predicted to be living with a sight-threatening eye health condition and an extra 74,000 Londoners will have sight loss.
We know that losing your sight can have significant impact on multiple areas of your life. It can be harder to maintain physical health, it can take a toll on your mental health and it can make finding and holding down a meaningful job a lot harder.
Looking after your own physical health in a sight-dominated society is a real challenge. In my GP surgery we have leaflets and posters on the walls pointing you towards support services, but what if you can’t see them? Being able to see the instructions on a medicine bottle, to read a letter about a follow up appointment, to cook for yourself and to travel around freely are some sight-dependent daily tasks we take for granted.
Then there is your mental health to consider, both the immediate shock of diagnosis and when dealing with an ongoing long term condition.
Diagnosis can be a traumatic event that changes a person’s life forever. But the Royal National Institute for Blind People (RNIB) found that only 17 per cent of people were offered any emotional support at the time of their diagnosis. Think about being told you might lose your eyesight and then having to walk out of the clinic all alone. We need to change this. We need physical health services to be aware of the psychological impact losing your sight might have and guide patients to early support before mental health problems develop.
Support needs to be on-going too. Our recent investigation into mental health found that people who experienced sight loss had higher rates of depression, anxiety and social isolation.
This might have something to do with employment. People who are registered blind or are partially sighted have a particularly hard time finding jobs - only a third are thought to be in employment. This compares unfavourably to disabilities as a whole - where almost half of all disabled people are in employment – and all adults, where the employment rate is 75.1 per cent. But these days, with the right specialist support and technology, people with eye health conditions can do a wide range of highly skilled jobs. There are organisations doing fantastic work here, helping blind and partially sighted people into work, but with the help of the Mayor we could do so much more.
The thing is, losing your sight is not inevitable. Too often I have patients come in to my surgery who think that deteriorating vision is just part of getting older. It’s not! If we catch symptoms early many cases of sight loss could be prevented.
Hundreds of thousands of Londoners are living with eye health conditions. Sight loss can be severely damaging for both mental health and physical health. Sight loss negatively affects your chances of employment. And most importantly, we could be preventing a lot of sight loss cases. So why aren’t we?
The healthcare system is under real pressure at the moment. People are losing their sight because of delays in the system. The RNIB has surveyed clinics and found that a shocking 94 per cent of staff don’t think that they can keep up with rising demand. But pressure isn’t an excuse. We need to act. We need to deal with eye health more efficiently and improve capacity.
At the same time, we have to be consistent. It can’t be right that the service you get from an eye health clinic still varies depending on what postcode you live in. The Mayor can be the spearhead that brings together all the different players in the eye health sector and the catalyst for change. Here at the London Assembly Health Committee we are calling for a London-wide eye health strategy.
And to put it simply, you need to go to the opticians. The NHS recommends that most people should have an eye test every two years, yet over a quarter of UK adults have not done so. We need a fundamental shift in how we see the opticians: it’s not just where you go to buy your glasses, but an essential health check. We need to keep pushing to get that message across in a way that makes sense to people in their everyday lives.
Ultimately, we are failing every single person who loses their sight when it was avoidable, and then we are further failing them with a society that makes sight loss into a disability through a lack of support. The problem runs deep and there is no quick fix. But we can do better, and we should.
Dr Onkar Sahota AM is Chair of the London Assembly Health Committee. Read the Health Committee report ‘Eye health - preventing sight loss in London’’.