Over 2.2 billion people worldwide suffer from visual impairment and, sadly, almost half of those visual impairments could have been prevented or avoided. Thursday 13 October is World Sight Day. The charity responsible for the annual campaign, the International Agency for the Prevention of Blindness (IAPB), this year focuses on the importance of eye care and access to eye care services, without which it is expected that the proportion of people with visual impairments will increase in the future.
One simple way to take care of your eyes is to attend regular sight test appointments with your optician. An optician will assess your eyes for any changes in your vision and advise whether you may need spectacles to help improve your vision. However, they will also look for early signs of more serious eye conditions such as glaucoma, age-related macular degeneration and cataracts.
Age-related macular degeneration (AMD) is a condition that can cause a variety of visual symptoms including distortions (straight lines bending), reduced central vision, and printed words appearing blurry. AMD is the biggest cause of sight loss in the UK, affecting over 600,000 people. It is estimated that there are 39,800 new cases of AMD in the UK every year. The condition usually affects people over the age of 50, but other risk factors include smoking, high blood pressure, being overweight and having a family history of AMD.
There are two forms of AMD – dry and wet. Dry AMD is most common, affecting 90% of people who have the condition. It causes a slow deterioration of the cells of the macula, so for most people it develops over many months or years. This means that they can often carry on living as normal for some time, without noticing any visual impairment. There is currently no treatment available for dry AMD.
Wet AMD, on the other hand, can develop very suddenly and cause a person’s vision to deteriorate quickly over a matter of weeks or months. It occurs when abnormal blood vessels grow into the macula, leaking blood or fluid which causes scarring. This can cause a person to suffer rapid loss of central vision, and blurry or distorted vision, as well as reduce a person’s ability to see colours or make out fine detail. Although people affected by the condition are not usually at risk of losing all vision - as the ability to see peripherally remains - they are often unable to drive, read, watch TV or recognise the faces of their closest friends and family.
Unlike the dry form of macular degeneration, wet AMD can be treated through regular injections of drugs into the eye to stop the growth of abnormal blood vessels. While vision that has already been lost cannot usually be restored, the injections slow the growth of abnormal blood vessels, reducing macula scarring. It is understood that the injections prevent worsening vision in nine out of ten people. Some patients do not respond to the injections and instead may be offered a form of laser treatment.
Wet AMD can only be treated successfully if it is diagnosed early and action is taken quickly. In fact, people who develop wet AMD can lose their sight as quickly as within three months if the condition is not diagnosed and treated. The Royal College of Ophthalmologists, in its guidelines, emphasises the need for urgency when the condition is diagnosed, and states that suspected wet AMD cases should be treated within two weeks of being identified.
As with many medical conditions, it is particularly true of wet AMD that the best outcomes are associated with early intervention. In reality, however, less than one third of patients receive a diagnosis from a retinal specialist within seven days of being suspected of having the condition, and many do not start treatment within two weeks of first suspicion. Delays can occur because of referrals from opticians or GPs being sent with insufficient information or failing to state the urgent need for specialist intervention. Other reasons for delays are administrative failings in specialist ophthalmology clinics.
Arran Macleod, a solicitor in the clinical negligence team specialising in ophthalmic claims, comments: “The importance of a person’s sight cannot be underestimated, yet many people do not go to their opticians for regular sight tests. Only a specialist eye doctor has the expertise to identify an underlying condition - which in its early stages may not be causing any problems - and we should all regularly visit our opticians to check on our eye health.
“However, even for those who do obtain regular sight tests, we continue to receive approaches from people who tell us that, despite seeing their optician, they have experienced delays in their treatment – whether delays in their onward referrals or delays caused by the hospital - and that they have suffered an injury to their sight as a result. As summarised, ophthalmic conditions such as wet AMD can progress very quickly and, if treatment is not provided within a reasonable timeframe, the deterioration in the person’s vision, which is often irreversible, can be devastating.”
If you have any concerns about delays in the treatment of your eye condition, please do not hesitate to contact one of the specialist oncology solicitors in the clinical negligence team.