Are sight and hearing undervalued?

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.