There is a saying that you do not value something until you do not have it. So, it may be the case that, because most people have sufficient sight and hearing, they underestimate the extent of need within the UK population. However, the prevalence of sight and hearing impairment increases with age and contributes significantly to the experience of social isolation and loneliness among older people as it impedes their ability to engage with their community. The UK National Eye-Health and Hearing Study (UKNEHS) (2019) sets out some uncomfortable facts regarding preventable sight loss and remedial hearing loss in the UK.
Approximately 50% of people lose their vision through a preventable cause, and more than 100 people under 40 years of age lost their vision due to glaucoma last year, with sight loss costing the UK more than £28 billion per year (UKNEHS, 2019). In the absence of a national prevalence database, it is estimated that about 2 million people are partially sighted, with over 200 000 being classified as blind, and it is predicted that the numbers of those visually impaired will increase to over 3 million by 2034 (UKNEHS, 2019). About 250 people begin to lose their sight every day and, yet, many ignore the first signs and do not seek advice from an optometrist or doctor. Sight loss is more common in women than men and older people, with 1 in 5 of those over 75 years living with sight loss. People from ethnic minorities and those with learning disabilities are also at greater risk of sight loss (UKNEHS, 2019). The five leading causes of visual impairment and sight loss are: age-related macular degeneration, cataract, diabetic retinopathy, glaucoma and under-corrected refractive error. In the absence of a unified eye health strategy, eye health policy varies across nations and regions, and access to general advice and treatment, including specialist care, occurs via optometrists under a General Ophthalmic Service contract, which includes eligibility for free sight tests. Approximately 17 million sight tests are performed annually, with the mean interval between tests being 26 months, but many do not access routine eye services. Since 2014, there has been a community-based NHS diabetic eye screening programme (NHS England, 2019) to identify those with deteriorating vision but, again, uptake varies.
‘Sensory loss has a profound impact upon the everyday lives of individuals.’
It is thought that 11 million people live with hearing loss in the UK, that is, one in every six people, and this consequently has an impact on daily communication within all settings and social relationships (UKNEHS, 2019). It is estimated this costs society £25 billion. Like vision loss, the number of people with hearing loss is predicted to increase to 14.5 million by 2031 (UKNEHS, 2019). Hearing loss is more common among older people and veterans and increases the risk of dementia and depression. And, as with the first signs of sight loss, most people who notice a change in their hearing do not seek help. Most people with severe or profound hearing loss live with their impairment for 10 years prior to getting a referral for appropriate treatment (UKNEHS, 2019). Again, there is no unified hearing policy with variable provision and much unaddressed hearing loss despite its consequences at both the individual and societal level.
Sensory loss has a profound impact upon the everyday lives of individuals, as well as having an economic and social cost to wider society. Services exist, albeit they may vary, but a major cause of treatment delay is the failure to access existing services. District nurses could advocate for better local provision for their clients and their families and signpost existing services so that preventable sight loss is avoided and hearing loss minimised to enhance quality of life.