Optometrists have an opportunity to maximise care for their patients after they depart the consulting room thanks to patient support bodies who follow up with crucial details about their disease, practical advice and psychosocial support. A recent partnership between a major optometry network and Macular Disease Foundation Australia is exemplifying this.
When patients are diagnosed with a form of macular disease, often it’s their first time hearing of the condition. It can be a discombobulating diagnosis and between optometrists, ophthalmologists and other health professionals, patients report sometimes feeling unsure of who’s actually managing them.
Accurate information about their condition can be hard to come by too. The experience can lead to patient disengagement – a harmful move when you consider that for neovascular age-related macular degeneration (nAMD – the most aggressive and sight-threatening version of AMD) there are effective treatments that can work to restore people’s sight while preserving their vision.
Macular diseases, including AMD, represent a significant public health concern globally. In Australia alone1 one in seven people over the age of 50 have some evidence of age-related macular degeneration (1.5 million Australians), and around 17% of those will experience vision impairment. Almost 15% of Australians aged over 80 have vision loss or blindness from age-related macular degeneration.
Positively, unlike previous generations, more patients are accessing eye tests than ever before. With more patients in regular eyecare, optometrists can detect conditions earlier and refer for diagnosis and treatment, preventing unnecessary vision loss. Despite this however, the statistics are still alarming for patients. For the 156,0902 Australians who currently have nAMD, an estimated 20% will stop treatment in their first year and 50% will stop their eye injections in the first five years.3 A further 22% are lost to follow-up, not attending their prescribed specialist and optometrist appointments.4
Dr Ben Ashby, clinical services director at Specsavers ANZ, says with this in mind, it is imperative that optometrists lean on their patient support body partners to ensure patients are receiving as much information and support as possible when caring for patients with macular disease.
“We know that patients often have many questions, concerns and problems after they leave an eye test consultation, and those who are directed to receive additional support and information from trusted patient support bodies are more likely to adhere to treatment and attend future appointments, helping to prevent vision loss in the long term,” he says.
“It is our goal, as providers of eyecare, to do all we can to set our patients up for success so that any eye conditions are effectively managed, and their vision is protected for many years to come.”
Specsavers and MDFA
Dr Ashby says Specsavers is working with Macular Disease Foundation Australia (MDFA) and to date its main focuses have been:
• Improving the referral rates of consenting patients to receive support from MDFA
• Assisting MDFA with the perspectives, feedback and opinions of optometrists to assist with improvements for how they support patients
• Helping to build awareness of MDFA from within its optometrist and patient network.
“In 2022, Specsavers and MDFA launched a pilot that targeted patients with nAMD and aimed to achieve these goals,” Dr Ashby says.
“The pilot involved 16 practices from around Australia who identified and referred patients with nAMD at levels consistent with the prevalence rates that were also seen in Australia’s National Eye Health Survey (0.24% of the population have been shown to have nAMD).5 A further 100-plus patients with other macular diseases were also referred from the practices, and these patients went on to receive support and resources also.”
Specsavers Elsternwick optometrist Ms Maddy Balson says MDFA is an organisation that can be trusted to support both patients and optometrists to reduce the impact and burden of macular diseases.
“They have resources for optometrists which we use regularly, including an Amsler grid, which I often get my patients to use weekly to detect any changes in the macula between visits,” she says.
“MDFA is a great resource for educating patients as they have online and in person education for patients, carers and optometrists, as well as support programs for patients and family. MDFA also funds extensive research to further advance macular disease detection and treatment outcomes.”
Dr Kathy Chapman, CEO of MDFA, says the Specsavers nAMD pilot led to many insights and learnings that were used to inform MDFA’s new patient support program, My Eyes.
“MDFA values our collaboration with Specsavers and optometrists to improve the visual outcomes of people living with macular disease,” she says.
“Working closely with the Specsavers network of practices across Australia, the nAMD pilot allowed us to communicate with a pool of patients and optometrists, gaining valuable insights and data on different and improved ways of supporting optometrists with the right information, but also importantly supporting patients to live better with their macular disease. It helped feed into the development of our newly launched patient support program.”
MDFA’s New My Eyes Program
Officially launched this Macula Month (May 2024), My Eyes is Australia’s first, free, national, macular disease patient support program and has been designed for people with newly diagnosed or existing AMD.
Dr Chapman says the service has been developed following extensive research involving people with macular diseases, their carers, and ophthalmologists, as well as the learnings from the nAMD Specsavers pilot.
“Feedback from patients and carers revealed a desire for more practical and emotional support throughout the treatment and disease journey, beyond what they might receive in their visits with health professionals,” she says.
My Eyes provides three main areas of support tailored to a patient’s level of vision, diagnosis and current perceptions about their wellbeing: disease information, practical support and psychosocial support.
“We launched the program as a pilot in November 2023, and have been pleased to see the positive feedback from patients and their optometrists already coming in,” Dr Chapman says.
One patient involved in the My Eyes service shares how the My Eyes Program helped him better manage his AMD.
“I am pleased to be part of the My Eyes program, having struggled with age-related macular degeneration. Initially I was lacking accurate information, and the information I received from various sources was often misleading and incorrect. It wasn’t until I visited an optometrist for a glasses check that I was introduced to the My Eyes service provided by the MDFA organisation,” he says.
“I discovered the service through MDFA and found their assistance invaluable. The MDFA team provided clear and accurate information, helping me understand my condition and manage it effectively. Grateful for the free and quality support, I appreciate the comprehensive knowledge gained through the My Eyes program.”
Any optometrists who wish to refer patients to MDFA’s My Eyes program can do so via Oculo or on the MDFA website: www.mdfoundation.com.au/refer-to-us/.
Looking ahead
Dr Ashby says the the Specsavers-MDFA partnership has been aimed at improving outcomes and quality-of-life for people affected by macular diseases.
“Specsavers encourages more optometrists to connect their patients with macular disease to MDFA. Optometrists need to make the most of the care that is available for patients after they leave the testing room, as patient support bodies such as MDFA can help to follow up on patients’ practical and clinical needs, as well as address their psychosocial well-being,” he says.
“Moving forward, continued collaboration with MDFA and other patient support bodies will be instrumental in advancing optometry care and transforming the lives of individuals living with eye conditions.”
2. Casten R, Rovner B. Depression in Age-Related Macular Degeneration. J Vis Impair Blind. 2008;102(10):591-599. PMID: 20011131; PMCID: PMC2792986.
3. Cimarolli VR, Casten RJ, Rovner BW, Heyl V, Sörensen S, Horowitz A. Anxiety and depression in patients with advanced macular degeneration: current perspectives. Clin Ophthalmol. 2015 Dec 30;10:55-63. doi: 10.2147/OPTH.S80489. PMID: 26766899; PMCID: PMC4699633.
4. Bradley, P., Mitchell, J., & Bradley, C. (2005, September). Peer support for people newly diagnosed with macular degeneration: a pilot study. In International Congress Series (Vol. 1282, pp. 211-215). Elsevier.
More reading
Evolving GA landscape prompts RANZCO AMD referral pathway update
Turning our attention to age-related macular degeneration – Specsavers
References
1. https://www.mdfoundation.com.au/about-macular-disease/age-related-macular-degeneration/amd-overview/
2. amazonaws.com/s3fs-public/Deloitte_Eyes_on_the_ Future_Report_web.pdf
3. Pharmaceutical Benefits Advisory Committee – Drug Utilisation Sub Committee (2018). Ranibizumab and Aflibercept: Analysis of Use for AMD, DMO, BRVO and CRVO. Accessed www.pbs.gov.au/pbs/industry/listing/ participants/public-release-docs/2018-05/ranibizumab_and_ aflibercept__analysis_of_use_for_amd%2C_dmo%2C_b.
4. Obeid A et al (2018). Loss to follow-up among patients with neovascular age-related macular degeneration who received intravitreal anti-vascular endothelial growth factor injections. JAMA Ophthalmol. 2018;136(11):1251-1259.
5. Foreman, J., Keel, S. et all. 2016. The National Eye Health Survey 2016. As published https://www.vision2020australia.org.au/wp-content/uploads/2019/06/National-Eye-Health-Survey_Full-Report_FINAL.pdf
