In the Summer edition of NCBI News we told you of a new report into the cost of sight loss in Ireland, commissioned by NCBI and carried out by Australian company Deloitte Access Economics. Now that the report is launched we bring you some interesting facts about the cost of sight loss in Ireland, now and into the future.

The report, entitled The Cost of Sight Loss: the economic impact of vision impairment and blindness in the Republic of Ireland, was officially launched by Minister for Health Dr. James Reilly on 26th September. It reveals that the real financial cost of vision impairment to the state is €386 million for 2010 and that the country has 224,832 people living with low vision and sight loss.

Professor Colm O’Brien of the Mater Hospital gave a comprehensive overview of the Cost of Sight Loss Report and warned that the numbers affected will rise to 271,996 with a cost to the state of €449 million by 2020. This cost to the Irish economy not only includes health care expenditure, but also incorporates the value of caregiver time, lost productivity (unemployment) due to impaired vision, and efficiency losses due to government-funded eye care and welfare payments to the blind.

Speaking at the launch the Minister for Health said: “I am delighted to be here this morning, because this morning is all about information. The findings, which make for sobering reading, are undoubtedly the most comprehensive data currently available on the burden of visual impairment and blindness in Ireland. I am also very grateful to the NCBI for commissioning this report; given the current economic challenges which face this country a report like this is very welcome, it has much to offer to the kind of health system that I am working towards developing, one which ensures that the patient and the tax payer receive the greatest return on scarce resources, consistent with quality and safety”.

The minister thanked NCBI for commissioning the report and while he was non-committal on the question of developing a Vision Strategy he did not rule it out either.

Des Kenny told NCBI News, “The study’s findings represent the most definitive data currently available about the cost of vision loss in the Republic of Ireland. The burden placed by vision loss on the Irish healthcare system and wider economy will continue growing unless greater steps are taken to detect and treat eye conditions that cause vision impairment. This is why we desperately need the vision strategy that is now a number of years overdue. We are hopeful that recent meetings with the Department of Health show that the strategy will be forthcoming soon.”

Des Kenny went on to say: “We expect the costs of vision impairment and blindness to increase alongside population ageing in Ireland. This trend could be countered through regular eye screening for the elderly, people with diabetes and other groups at greater risk of eye disease, as well as research and funding for treatments to manage AMD, retinopathy and cataracts”.

“This is the first study to estimate the total prevalence of vision impairment and blindness in the Republic of Ireland, as well as the associated costs to the economy. Previous studies have only reported the number of people registered blind, or the prevalence of broader vision impairment in children or specific communities,” says Adam Gordois, Associate Director of Health Economics and Social Policy at Deloitte Access Economics, Sydney. “In addition to health care costs, sight loss incurs substantial knock-on costs to the economy that should not be ignored. In fact, we estimate 43% of the total financial cost is from unemployment due to impaired vision, and the associated loss of productivity to the Irish economy, and the value of caregiver time to assist the vision impaired with everyday activities. Our results highlight the need for intervention at a national level to manage conditions that lead to vision impairment.”

Recommendations for reducing the burden of disease

The burden highlighted in the report can potentially be reduced through effective prevention, detection and treatment of eye conditions that lead to vision impairment and blindness. Three eye care interventions are evaluated in the report and found to be cost-effective according to World Health Organisation thresholds:

• An educational program aimed at increasing the uptake of eye tests in people aged 70 years and older, who are at risk of age-related macular degeneration and other eye disease;
• Free annual eye tests for people aged 10 years and older with diabetes, who are at risk of diabetic retinopathy leading to vision loss;
• Increased hospital funding to reduce cataract surgery waiting lists.

The burden could also be reduced through greater uptake of eye examinations, more research and funding into new treatments for the main causes of vision loss, and increased affordability of eye care services and spectacles for the Irish population.

Author and historian Tim Pat, Coogan gave a cogent account of sight loss from his personal perspective: the difficulties he has encountered while researching his work since his condition was diagnosed in the late 70s. He praised the medical professionals and said: “Everything that can be done on a human level is done in this country, within the straight jacket of the resources available”. Spending money on a vision strategy “is really money very well worth spent. Sight loss is really an elephant in the room in Irish health, in Irish society. I really do commend the efforts of NCBI and all the eye professionals. I appeal to the minister, whatever problems we might have within the health services, get money to fund this sight loss prevention and to support the wonderful low vision aids provided by NCBI”.

The report is available at http://www.ncbi.ie/about-ncbi/ncbi-publications and is also available in Braille and audio.

NCBI is grateful to Novartis Ireland for its significant educational grant which part funded this report, the first comprehensive attempt to cost the societal burden of vision impairment and blindness for the whole of Ireland.