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Eye Health 2019

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Making avoidable blindness a thing of the past B L I N D N E S S Design Joanna Bird Sara Gelfgren Kellie Jerrard Harry Lewis-Irlam Celina Lucey Colm McDermott Samuele Motta Jack Woolrich Book a free eye test Visit specsavers.co.uk/free for participating stores Don't lose the picture 50% of sight loss is avoidable Free eye test: Visit site to download voucher by 19 October 2019. Expires 31 October 2019. Not applicable in Scotland, CI & IOM or if eligible for NHS eye tests. T&Cs apply. ©2019. Source: RNIB and Specsavers State of the Nation Report – Eye Health September 2017. "More than 50 per cent of blindness is pre- ventable and the main causes are disease processes that could have been detected early enough to slow it down, or uncor- rected short or long sight," says Louise Gow, specialist lead for RNIB. "No one should be visually impaired because they haven't had access to care to prescribe glasses." The major disease causes of blindness – diabetic retinopathy, cataracts, glaucoma, wet age-related macular degeneration (AMD) – are all amenable to treatment if diagnosed early enough. "We should be making sure that in this country people are not losing their sight when it could have been prevented," says Ms Gow. "We have a fantastic ophthalmol - ogy service on the NHS, but it is under so much strain. Lots of patients experience delays for follow-up appointments and get- ting into the system, so they present with later-stage eye disease or do not even access the services and treatment they need. We need more ophthalmologists trained, and to utilise the skills of optometrists and dis- pensing opticians to take some of the strain from hospitals." Dr Andy Cassels-Brown, medical director of the Fred Hollows Foundation, an interna- tional development agency working to elim- inate avoidable blindness, underscores the need for medical and technical advances to be matched with system upgrades. "While new technology is part of the solu- tion to eliminating avoidable blindness, it won't be the single solution," he says. "Breakthroughs will also come in the form of new models of care that deliver services to more people and those most in need. Social and economic ramifications of sight loss are too big to ignore, but an array of inspiring projects is helping to tackle one of the biggest healthcare battles of our time ight, the precious sense that brings us perspective and wonder, is under unprecedented attack. Despite huge clinical and technological advances, record numbers of people are needlessly going blind. The economic burden of sight loss has been estimated at £28.1 billion a year in the UK, yet more than 50 per cent of blindness is avoidable. These stark statistics are made even more disturbing by the fact that, while health and longevity profiles across all disabilities are improving, sight loss is becoming worse. Research projects are bringing us bionic eyes, stem cell regrowth and artificial intel - ligence (AI) that can combat the ravages of eye disease. But they are ranged against for- midable harbingers of darkness in obesity, outmoded systems, poor funding and age- ing populations. It is a healthcare battle of our time. The rise of type-2 diabetes has led to an alarm- ing climb of diabetic retinopathy over the last decade and, with more than five mil- lion people predicted to have the condition by 2025, the burden can only increase. The maelstrom's force is accelerated by an ageing population suffering from nat- ural sight loss and a stressed healthcare system that results in huge delays for basic sight-saving treatment and an acute short- age of ophthalmologists in training. The All-Party Parliamentary Group (APPG) on Eye Health and Visual Impair- ment reported in June 2018 that sight loss is projected to increase by more than 10 per cent by 2020 and by 40 per cent by 2030. Ophthalmology has the second highest outpatient attendance of any specialty with a 10 per cent increase over the last four years to almost 7.6 million appointments in 2016- 17 in England, yet there is a chronic short- age of ophthalmology consultant posts. A report from the Royal College of Oph- thalmologists in 2018 warned that 67 per cent of hospital eye units were using locum doctors to fill consultant posts, an increase of 52 per cent since 2016, and that around 25 per cent of the current specialist workforce is nearing retirement. Lack of provision has a cascade impact on health and wellbeing as evidenced by APPG research, which found 70 per cent of patients felt appointment delays and can- cellations caused them anxiety or stress. Mikaela Aitken Brisbane-based freelance journalist and copywriter, she specialises in urbanism and design and is a regular contributor for Monocle. Martin Barrow Former health editor, news editor, foreign news editor and business news editor at The Times, he specialises in the NHS and social care. Danny Buckland Award-winning health journalist, he writes for national newspapers and magazines, and blogs about health innovation and technology. Nick Easen Award-winning journalist and broadcaster, he writes on science, technology, economics and business, producing content for BBC World News, CNN and Time magazine. Cath Everett Journalist specialising in workplace, leadership and organisational culture issues, she also writes about the impact of technology on business and society. John Illman Author and former national newspaper health editor and medical correspondent, he is a visiting lecturer at the University of Cambridge and University of Westminster. "Governments will need to oversee health systems, drive the adoption of affordable technologies and make them available to the most in need." The need to harness brilliant innovation with the more prosaic system design is writ large in glaucoma, a condition that slowly damages the optic nerve and erodes sight. Around 900,000 people in the UK have the condition, but public awareness is so low that around 500,000 are unaware they have it and could suffer irreversible sight loss. Regular eye tests and faster routes to treat - ment could turn around an insidious prob- lem that will lead to the loss of livelihood and independence. "The optical profession has started asking itself why enough people don't get tested and one of the answers is for opticians to follow pharmacists in providing more ser- vices to patients and relieve the burden on GPs," says Karen Osborn, chief executive of the International Glaucoma Association. "People understandably think of eye checks as a case of if you need spectacles or not, so a cultural change in understanding is needed because there are so many other health con- ditions that can be picked up." It is a sobering challenge, but eye health is awash with inspiring projects that have taken bionic eyes and regenerating optic cells from hope to reality. Professor Paulo Stanga of Manches- ter University has successfully implanted bionic eye systems – a prosthesis linked to a visual display unit in a pair of spectacles – to restore some functional sight to patients with retinitis pigmentosa, an inherited dis- ease that causes blindness and AMD. Trials, funded by the NHS, are continu- ing and proving that a future where avoida- ble blindness is drastically reduced is more than just a dream. Research is also progressing at London's Moorfields Eye Hospital NHS Foundation Trust to tackle the diagnostic challenge. Its collaboration with DeepMind Health, part of Google's healthcare division, uses AI technol- ogy to detect eye conditions automatically in seconds and triage patients to the right treat- ment, reducing the chances of sight loss. It claims a 94 per cent accuracy rate on eye-scan analysis and could, if clinically validated, reduce diagnosis time, release consultants for other work and create a data reservoir to improve future research. Dr Pearse Keane, consultant ophthalmol- ogist at Moorfields Eye Hospital, says: "Our work with DeepMind Health is using artifi- cial intelligence to detect abnormalities in patient's eye scans. This has the potential to provide a much faster diagnosis, which is vital in preventing sight loss from a number of conditions, including age-related macu- lar degeneration and diabetic retinopathy." Avoidable blindness is verging on a national tragedy and it will need a con- certed effort from campaigners, clinicians, scientists, and public health and govern- ment policy to ensure people can retain the gift of sight throughout their lives. Distributed in Guest editor Benedict Buckland Head of production Justyna O'Connell Head of design Tim Whitlock Managing editor Benjamin Chiou Associate editor Peter Archer Published in association with Although this publication is funded through advertising and sponsorship, all editorial is without bias and sponsored features are clearly labelled. For an upcoming schedule, partnership inquiries or feedback, please call +44 (0)20 8616 7400 or e-mail info@raconteur.net. Raconteur is a leading publisher of special-interest content and research. Its pub- lications and articles cover a wide range of topics, including business, finance, sustainability, healthcare, lifestyle and technology. Raconteur special reports are published exclu- sively in The Times and The Sunday Times as well as online at raconteur.net. The information contained in this publication has been obtained from sources the Proprietors believe to be correct. However, no legal liability can be accepted for any errors. No part of this publication may be reproduced with- out the prior consent of the Publisher. © Raconteur Media /eye-health-2019 @raconteur /raconteur.net @raconteur_london EYE HEALTH G L O B A L V I S I O N S C R E E N T I M E B R E A K T H R O U G H S Looking back on the decades-long mission to provide universal eyecare Myopia is on the rise, so screen time habits may need to change before it's too late 02 05 06 raconteur.net Danny Buckland S Contributors RNIB 2017 WHO 2016 250 1in5 of visual impairment worldwide is avoidable people lose their sight in the UK every day people will live with sight loss in their lifetime 0 BMC Health Services Research 2018 AGE-REL ATED MACUL AR DEGENER ATION ( AMD) IS THE LE ADING CAUSE OF SIGHT LOS S IN THE UK Years of healthy life lost per condition, by severity of sight loss; percentage refers to the total burden of disease caused by the condition 30,000 25,000 20,000 15,000 10,000 5,000 People think of eye checks as a case of if you need spectacles or not, so a cultural change in understanding is needed I N D E P E N D E N T P U B L I C A T I O N B Y 2 2 / 0 9/ 2 0 1 9 # 0 6 1 9 R A C O N T E U R . N E T Deputy editor Francesca Cassidy Digital content executive Taryn Brickner AMD Cataract Diabetic retinopathy Glaucoma Refractive error Other 39% 17% 8% 15% 13% 9% Blind Partial sight Low vision Publisher Richard Hadler DISCLAIMER: Content in this publication should not be used as medical advice – please ensure you always seek the help of a qualified medical professional. Emerging tech is pushing the boundaries of diagnosis and treatment >75% International Agency for the Pre- vention of Blindness 2019 NATIONAL EYE YOUR VISION MATTERS HEALTH WEEK MONDAY 23 – SUNDAY 29 SEPTEMBER 2019

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