Diagnosis and treatment of certain eye conditions and referring patients on for specialist care to an eye doctor is a crucial role of a G.P in the management of their patients’ eye health. With increasing incidence of blindness due to an ageing population in Ireland, knowledge of ophthalmology is becoming increasingly more important to General Practitioners.
The central mission of the ICO is to reduce the number of annual cases of preventable blindness and sight loss amongst patients in the risk groups and to improve their quality of life, providing more effective management of patients with eye conditions through effective clinical pathways and interventions.
There are currently 224,832 people living with low vision and sight loss in Ireland. This is estimated to increase to 271,996 by 2020. Within this, there are approximately 13,000 blind people living in Ireland today, with this expected to increase to 18,000 by 2020. Given the growing incidence in key underlying causes of sight loss such as obesity and diabetes, this could represent an underestimate if Ireland does not take a comprehensive approach to early detection and treatment strategies.
Up to 75% of blindness and vision loss can be avoided. Early detection and referral to an eye doctor can ensure that patients are diagnosed and treated appropriately. When sight loss cannot be prevented, timely referral to an eye specialist and low vision and social care rehabilitation services can be life-changing for a patient.
When people start to lose their sight they often report difficulty reading small print, cooking, mobility, taking medication and recognising faces. Visual acuity, contrast sensitivity and visual field may be affected.
Macular degeneration, glaucoma and diabetic retinopathy are the most common causes of sight loss among older people in Ireland. Uncorrected refractive error and cataract are the most common causes of avoidable sight loss. There are variations in the prevalence of common eye conditions between different ethnic groups.
Ophthalmologists determine whether a person is eligible to be certified as sight impaired or severely sight impaired. People with visual acuity ≤ 6/60 can be certified sight impaired (partially sighted) and < 3/60 can be certified as severely sight impaired (blind).
Sight loss may be due to, or present alongside, other health conditions. Health professionals should consider the key issues affecting people with conditions such as stroke, diabetes, falls, learning disabilities, dementia, sleep apnoea is linked with eye conditions, smoking - cessation programmes help reduce the risk of sight loss in age-related macular degeneration (AMD).
For an appointment to see any medical specialist working in the HSE, including eye doctors, a GP should send a referral letter to the consultant. Early detection and referral facilitates diagnosis, treatment and rehabilitation.
Advice on driving standards for patients with visual impairment is available here
ICO GP Liaison Manager
Dr Garry Treacy is the ICO’s dedicated GP Liaison Manager and is responsible for co-ordinating all communications with GPs, including the notification of relevant events and ophthalmology courses for GPs.
Dr Treacy is a former ICGP member having practised as a general practitioner during the 1980’s. He is currently a practising community ophthalmologist.