Eye care in the country, like other care, is overburdened. There are approximately one million patients in Sweden with glaucoma, diabetic changes, macular diseases, various hereditary retinal diseases and other conditions that require regular eye examinations by eye care professionals, as demonstrated by a 2010 SBU report. Combined with scarce resources in longer queues for care. Waiting lists in turn lead to the start of care interventions too late and in the worst cases can lead to blindness.
Cataracts, glaucoma, a common disease and one of the conditions that require regular follow-up. According to SBU, about 200,000 Swedes suffer from glaucoma – about half of them without even knowing it. Once you start noticing you have glaucoma, your vision is often significantly affected. Existing research is beginning to provide new explanations and treatment options, adding to the impetus for early detection.
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For many years, eye care has been used to work with both public and private providers. The same situation applies to the optometrist. At the same time, the technical equipment has greatly improved in recent years, which provides the opportunity for good survey methods in many places in Sweden.
A good way to have regular check-ups while shortening waiting lists in eye care is to have more trained optometrists perform a greater proportion of all examinations. A government investigation already in 2009 highlighted the importance of optometrists, both socially and economically, and for patients. Unfortunately, it has remained oddly steady ever since.
One explanation might be that the so-called 1995 optometrist regulations were never updated. The nearly 30-year-old regulation is based on old and outdated conditions and misses both comprehensive technical development and changes in optician training that have been made. The National Council on Health and Welfare began reviewing the regulation in 2018, but it was never completed.
Almost one in four optometrists in Sweden are trained, which means that there is a very good willingness to improve eye care if only the optometrist regulations are updated.
Another explanation is that there is a lack of active effort between the specialist physician level and the optometrists to synchronize efforts in the future. During 2019 and 2020, the trials were conducted in Skåne and Östergötland, which means that optometrists deal with routine examinations of glaucoma patients. It relies on clear referral procedures to find suspected eye changes.
In the Skåne region alone, eye care is provided by 4,500 annual routine visits, which shows that there are great opportunities to shorten waiting lists significantly. Patient representatives from both the Swedish Glaucoma Society and the Swedish Diabetes Association follow the two research projects closely.
Stakeholders – government offices, the National Council for Health and Welfare, Swedish municipalities and regions, the Swedish Ophthalmologists’ Association, the Swedish Ophthalmologists’ Association and patient organizations – must work together. There are opportunities to develop quality and close care also in eye care. It is the patients who are affected when the growth is allowed to remain dormant.
Sven Olof EdvinsonPresident of the Swedish Glaucoma Society
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