Specsavers’ latest snapshot into Australian eye health has revealed referrals for eye disease are soaring to unprecedented levels thanks to the systematic use of imaging technology and ophthalmology-led education, as well as other clinical interventions.
In its latest report, titled the Specsavers Eye Health Report 2019-20, the optical chain also details how it is identifying cases of glaucoma much earlier than before, while also bringing its overall detection rates further into line with prevalence estimates.
Released to Insight last week, the report builds on the company’s inaugural State of the Nation Eye Health Report published in October last year. Billed at the time as the most in-depth examination of Australian eye health, it established a yardstick to measure future outcomes against and highlighted the need for greater sector-wide collaboration.
This year Specsavers analysed data from 8.5 million patient journeys to quantify the impact of its strategies, as well as the Australian public’s attitudes towards eye health. It is the largest data-set of its kind available in the region, and this year increased by another 3.5 million data points.
The company reports it is continuing to make significant inroads towards the detection and referral of glaucoma and diabetic eye disease, partially driven by its initiative to use optical coherence tomography (OCT) on every patient.
The figures show glaucoma referrals have doubled over the past two years. Between July and December 2017, when OCT was installed in just 3% of stores, Specsavers referred 10,562 of these patients to ophthalmology. The figure rose to 20,516 between January to June this year, when OCT was incorporated in 83% of practices.
By 31 July this year, glaucoma referrals had further increased to 24,477. With OCT now available across all 334 Australian stores, referrals are projected to reach 42,000 by the end of the year, an increase of 19% on 2018 (34,053) and 64% on 2017 (15,145).
Overall, 86% of glaucoma referrals have been classified as appropriate by the attending ophthalmologist, with 14% being false positives.
“The findings [also] indicate that more than half (53%) of the referrals to ophthalmology in 2019 were new referrals. This closely aligns with the findings of the Blue Mountains Eye Study from 1992-1994,” the report stated.
“Furthermore, new glaucoma diagnoses made up the majority of referrals for those under the age of 49; 72.8% for people under the age of 40 and 68.7% for people 40 to 49.”
While the systematic use of OCT has been the catalyst for significant changes to patient care, Specsavers states the introduction of other clinical interventions are also having a measurable impact.
This includes increased utilisation and same day performance of visual fields on at-risk patients, use of the RANZCO Referral Pathways, the Oculo e-referral platform and Optometry Benchmark Reporting.
Another contributing factor has been the ophthalmology-led education workshops that were recently introduced for Specsavers optometrists. Glaucoma referrals have increased by 35% in practices that have attended the program while also reducing the level of false-positive results.
Tackling diabetic eye disease
Specsavers has also recorded a major rise in diabetic retinopathy detection levels. At 31 July, 7,028 patients were referred to ophthalmology for the disease. Based on the current referral rates, this figure is projected to reach 12,000 patients by the end of the year, an increase of 34% on 2018 (8,982) and 205% on 2017 (3,931).
“This year, following enhancements to Specsavers’ patient management system to enable optometrists to simply and consistently identify patients with diabetes, and the introduction of the KeepSight portal, for the first time we are able to properly start measuring eye health outcomes for this subset of the total population,” the report said.
“The ability to analyse data specifically for patients with diabetes opens up many opportunities to better understand eyecare for this at-risk group as it currently stands, which will provide direction and impetus to enhance standards of care and accessibility.”
Specsavers is currently registering 1,500 diabetes patients every week to the KeepSight database to ensure they get regular reminder to get their eyes checked. Total registrations from Specsavers optometrists are forecast to reach 36,000 by the end of the year.