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How optometry is bouncing back

Specsavers data has quantified the impact of extended lockdowns on Victorian eye health for the first time. DR BEN ASHBY delves into the data, and explains why metropolitan Melbourne isn’t out of the woods yet.

The optometric industry, like most others, was significantly affected by societal changes in response to COVID-19. At the start of 2020, Specsavers had strategies in place to deliver eyecare to 3.6 million patients; to detect and refer 51,000 cases of glaucoma; and to register 200,000 Australians living with diabetes to KeepSight, helping to protect their vision from diabetic retinopathy.

Ben Ashby.

By the end of March, the focus quickly changed to ensuring access to care and appropriate triaging of those with urgent and critical needs, while keeping staff members and customers safe. Insight’s August issue reported that in March and April there were 600,000 fewer Medicare-funded optometry services compared to the previous year.

In the same two months, it is estimated 25,208 Specsavers patients who likely had eye conditions requiring specialist attention did not attend their appointments and 166,635 patients missed their routine eye test.

Optometric attendance rates 

Specsavers director of optometry Dr Ben Ashby says the resultant impact on eye health outcomes for patients became a topic of great focus for Specsavers. And as restrictions eased, the optical provider commenced prioritised recall of patients with existing conditions, which became a vital aspect of a data-driven strategy for recovery.

The volume of national Medicare-funded optometry services 2019 vs 2020. In March and April there were 600,000 fewer services compared to the previous year.

“Medicare data shows that from June onwards, optometry attendance rates have appeared to bounce back,” he says.

“The resumption of routine optometric services as restrictions eased across the country is noticeable. When considering Medicare reported 600,000 less optometric services in March and April alone, it is obvious the industry has worked hard to recuperate patients and offer eyecare services, whilst adapting to delivery of these services in line with COVID-safe government protocols.

We will continue to monitor the recovery of these patients to ensure we’re taking the appropriate measures to accommodate the demand for optometric services during this crucial time.”

For the first time, Specsavers has been able to show the impact on Victoria’s second wave on eyecare services.

The extended and significant lockdown period in Victoria skews January to October national data considerably. Medicare reports 564,074 less services in Victoria across this time compared to the same period in 2019, more than half of the national total of missed services (approximately one million), demonstrating the magnitude of impact on the eyecare system in Victoria.

A comparison of Medicare item 10915 across the same timeframe shows there were 26,675 fewer services nationwide in 2020 (9,943 excluding Victoria), providing some insight into how many patients with diabetes have likely missed their annual dilation in 2020.

Australia’s 2020 optometric Medicare services compared with 2019, excluding Victoria, demonstrating a considerable rebound from June onwards.

“We recognised this trend within the Specsavers dataset as well and took steps to prioritise recall for patients with diabetes and existing eye conditions as restrictions eased. We are continuing to monitor this data to inform how we adjust our communication with patients to ensure we’re addressing at-risk patients appropriately,” Ashby says.

Detection and referral rates 

National data shows that despite a significant reduction in routine attendance in April and May, the recovery has been relatively swift in terms of patients accessing eyecare once restrictions began to ease. Specsavers e-referral data shows a similar recovery for optometric disease detection and referral rates from May onwards.

“We monitored referrals for all eye conditions across 2020, concerned about the impact of the cessation of routine care due to COVID-19 restrictions,” Ashby explains.

“One particular concern was around detection of glaucoma as we know this is closely tied to routine eye testing, often occurring as an incidental finding in asymptomatic patients. We knew if new detection rates dropped, our industry would face larger, ongoing ramifications.”

According to Ashby, latest data shows this remains a risk for many patients in metropolitan Melbourne, where lifting restrictions have only recently enabled routine eyecare again. Here, Specsavers estimates more than 2,500 patients with undiagnosed glaucoma were unable to access routine care in lockdown.

“With the recent return of patients for overdue reviews and routine care, a proportional increase in detections has been seen. In November and December alone, an additional 730 glaucoma referrals have been made across Specsavers’ metropolitan Melbourne practices compared to the same period in 2019. While these numbers are encouraging, they still only represent a third of the estimated patients missed, indicating a longer recovery ahead,” Ashby says.

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