GPs and Optometrists: Attitudes to eye health

August 2010

In the UK, there are currently almost 2 million people living with sight loss. With our aging population, by 2050, this number is predicted to rise to almost four million.Over 50% of sight loss can be avoided.

Sight loss is also expensive. In 2008, an estimated £22 billion was associated with it – in treatment-related costs, indirect costs such as informal care and ‘quality of life’ costs such as financial hardship and depression.

Given this situation, you would expect the prevention of sight loss to be at the ‘top of mind’ among GPs and optometrists when meeting with their patients. New research by the RNIB has found, however, that most GPs feel they don’t know enough about the needs of people with visual impairment and that optometrists want more support and barriers removed to help them promote eye health.

The research findings: GPs

Among GPs, there is a large gap between knowledge and experience around treating eye conditions. Nearly three in five GPs feel that they are well informed about different eye diseases and conditions (59%) but when it comes to recognising symptoms, as a group they are only confident that they can recognise the symptoms of cataracts (only 2%say that they cannot spot these symptoms).

However a significant proportion are not confident in their ability to recognise diabetic retinopathy (38% not confident), glaucoma (39%) or the most common cause of blindness, age-related macular degeneration (53%).

GPs also need better information and education to help them understand the demographic dimensions of certain eye conditions. People from black and minority ethnic communities are at greater risk of some of the leading causes of sight loss. Despite this, only two in five GPs say that they are aware that certain eye conditions are more prevalent in some minority ethnic groups (43%). When asked which conditions patients from minority ethnic groups are more likely to develop, only one in 20 of these GPs are aware that they are more likely to develop glaucoma than white patients (5%).The risk of glaucoma is much higher for the black population compared to the white population. For example, the relative risk of Glaucoma between the black population and white population between the ages of 60 to 74 is thought to be over 4 times higher.

More worryingly, nearly two in five of those who say that they knew that ethnicity was a factor in certain eye conditions (38%) inaccurately believe that all of the conditions listed – cataracts, glaucoma, diabetic retinopathy and AMD – are more prevalent in some BME groups.

GPs know eye health is important but they need more support to promote eye health. Two in three GPs feel that eye health promotion is a vital part of their role (66%), but only a third believe they are well informed about the needs of people with visual impairments (31%). Furthermore, over a third agree that they face barriers promoting eye health (34%).

Above all else, GPs feel that they need training and guidance to overcome these barriers. They also request information materials to give to patients and literature to prompt awareness among GPs themselves.

The research findings: optometrists

As would be expected, optometrists are better informed about eye conditions than GPs but they would like more support so that they can promote eye health more than they currently do.

Three in five optometrists are well-informed about the needs of people with visual impairments (59%), while virtually all of them say that they are well informed about eye diseases and believe that eye health promotion is a vital part of their role (96% and 94% respectively agreeing with eachstatement).

However, on average they only spend 12% of their time promoting eye health, while one in six say that they spend no time at all promoting eye health in an average week (17%).

Coupled to this is the finding that over half of optometrists (53%) say that they face barriers in promoting eye health to their patients. This is a significantly higher proportion than the 34% of GPs who say that they face barriers.

Also unlike the GPs, optometrists do not see their own education and training as factors which impede eye health promotion, however they would like to work more closely with other services (63%) and feel that they too would benefit more from having information to give to patients (74%).

Almost a third (27%) agree that the need to prioritise sales within their optometry practice is a barrier to doing eye health promotion.

A full list of the barriers faced is included in table 1 on the following page.

Table 1: Thinking about the barriers that you face as an optometrist in promoting eye health to prevent avoidable sight loss, what could be done to overcome these barriers? Base: n=101 high-street optometrists

Table follows showing information in two columns, the first column denoting suggestions for overcoming barriers and the second column showing percentage of those who agree:

Percent
Information to give to patients / 74%
Joined up working with other local services / 63%
More statutory funding to promote eye health / 60%
Training and guidance on promoting eye health / 55%
Information/literature for you as an optometrist / 45%
More time with patients / 41%
Support to pay for services/glasses/medication / 35%
Translated information / 34%
Prioritising eye health above sales / 27%
Training on language/culture / 25%
Don't face any barriers / 7%

What does this mean?

Improving patient outcomes is at the heart of the government’s proposals for healthcare reform. Patients need to feel confident that when they visit their GP or optometrist with an eye complaint, their symptoms will be recognised and their needs met by correct referral, or that they receive the information they need to make the right decisions. This research has shown that this isn’t always the case.

However, with a few simple changes, we believe that a step change in the quality of eye health care can be delivered.

Firstly, if patient literature is made more widely available, optometrists can overcome some of the barriers they face when promoting eye health. With greater networks, and the chance to prioritise eye health this can be taken even further.

With better training and peer-to-peer information, GPs can increase their confidence in their ability to recognise the symptoms of eye conditions and improve their understanding of the prevalence of eye conditions among minority ethnic groups, ensuring that those most at risk access the right services.

The RNIB would like to see GPs and optometrists taking up this challenge of promoting eye health and improving outcomes – and we’re here to help them do that. The advantages for all of us – patients and healthcare professionals alike – should be plain to see.

RNIB July 2010

For further information about this research or RNIB's eye health work please contact the RNIB Media Relations team on

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