The HRindex worsens more rapidly with age at the parafovea, consistent with histologic findings of rod loss and its link to age-related degenerative disease of the retina. The HRindex and interocular differences could be used to screen for and separate the earliest stages of subclinical disease from changes caused by normal aging.
The health of the retina index captures the lowest threshold, usually obtained under photopic conditions, as well as the loss of flicker sensitivity with decreasing light level. The established limits of healthy aging may benefit from future studies in patients with ocular hypertension and/or glaucoma that are known to experience loss of flicker sensitivity.
In the clinics sampled, there appears to be an underprovision of emotional support (attentive listening plus constructive suggestions) and family support (emotional support and advice for family members) for visually impaired patients in the United Kingdom. There also seems to be some discrepancy in services that eye care professionals feel are available and previous reports by visually impaired patients of the service they receive. There is a need to develop standardised pathways across the United Kingdom, to solve some of these issues.
BackgroundSight loss has wide ranging implications for an individual in terms of education, employment, mobility and mental health. Therefore there is a need for information and support to be provided in eye clinics at the point of diagnosis of sight threatening conditions, but these aspects of care are often missing from clinics. To meet these needs, some clinics employ an Eye Clinic Liaison Officer (ECLO) but the position has yet to be widely implemented. The aims of this study were:(1) To evaluate the forms of advice and emotional support in eye clinics provided by ECLOs.(2) To determine the cost of the ECLO service per patient.MethodsMicro-costing was carried out using interviews, a survey and administrative data. The survey was completed by 18 of the 49 accredited ECLOs in the UK (37%) and provided information on the activities performed by ECLOs, numbers of patients seen per day, training costs incurred and the salary of the ECLOs.ResultsECLOs provided information about the services in eye clinics and the community, referral to social services, emotional support to patients and also other advice. The cost of an ECLO per patient per contact was £17.94 based on an average annual ECLO salary of £23,349.60 per year, reviewing on average 9.1 patients per day, in a 42 week year.ConclusionsThis study provides the first costing of support services in hospital eye clinics, providing a range of estimates to suit the circumstances of different clinics. The information can be used by local decision makers to estimate the cost of implementing an ECLO service.
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