400,000 A&E visits for minor eye conditions could be avoided

The Association of Optometrists (AOP) has said that between 62 and 78 per cent of eye emergency department attendances—amounting to up to around 400,000 cases a year—could be treated outside of hospital by trained community optometrists.

Patients presenting at A&E with minor eye conditions, such as conjunctivitis, dry eye, infections and some abrasions, could be redirected to community optometry services, easing the strain on emergency departments.

In England, there are nearly 780,000 A&E visits each year for eye problems, making them one of the top 10 reasons for attending emergency care.

Dr James Gagg, Vice President of the Royal College of Emergency Medicine, said: “It’s no secret that Emergency Departments (EDs) in England are under immense pressure at the moment, and we know our patients are being let down due to overcrowding and unacceptably long waits.

“Utilising community optometry services to ensure there is equitable access across England could save people with a variety of eye health problems from a potentially lengthy trip to a busy ED.

“We would welcome better-resourced community eye care, which could help deflect demand from A&E, accompanied by further measures from government to tackle the root causes of overcrowding and corridor care elsewhere in the system.”

Currently, access to NHS-funded urgent eye care varies across England due to inconsistent commissioning, creating a "postcode lottery" that leaves many patients without nearby care.

AOP chief executive Adam Sampson said: "Emergency departments should not be the default destination to manage eye problems.

"What this research tells us is that hundreds of thousands of patients each year end up in A&E because they conclude it’s their only option, but they could be treated by the highly trained optometry workforce based in the community."

He said the issue is not about capability but consistency of access.

Mr Sampson said: "It’s essential we have a service in place for everyone everywhere in England to treat eye problems in the community—the reality of the postcode lottery is that it deprives patients of access to care close to home.

"It is simply a no-brainer that the Government acts to ensure that every member of the public who has an eye problem should be able get the help they need on the High Street, in the same way the public can go to a community pharmacy for a range of health issues, regardless of where they live."

NHS-funded urgent and minor eye care services allow patients with symptoms such as red eyes, infections, flashes and floaters, or sudden vision changes to be assessed and treated by community optometrists.

In areas where these services are in place, they have been shown to reduce pressure on both A&E and GP services.

However, the lack of nationwide availability means many patients still default to emergency departments.

A 2024 report by PA Consulting for the AOP found that the community optometry workforce already has the expertise, equipment and capacity to handle significantly more cases in the community.

The AOP has written to the Secretary of State for Health and Social Care, sharing its report Taking pressure off Emergency Departments as part of its ongoing Eye care everywhere campaign, which calls for a standardised nationwide service.

NHS Emergency Care Data Set (ECDS) figures for 2024/25 show that eye problems accounted for three per cent of all ED visits, putting them among the top eight reasons for emergency attendance.

Of 25.8 million total ED visits, nearly 780,000 were for eye-related issues.

The AOP and other eye health leaders are calling for urgent action from the government to ensure consistent access to community-based eye care services, in line with broader NHS goals to move more care out of hospital settings and into the community.