Mind the chasm

5 May 2023
Spring 2023

The College’s Clinical Editor, Jane Veys MCOptom, on the gaps that exist in practice and between people

Do you ever ask yourself who are you not seeing for eye care, rather than just thinking of your current patient base?

Surely our aspiration should be that eye examinations are accessible to all, and all who require vision correction are prescribed the appropriate form of vision correction.

The number of people living with uncorrected refractive error is far greater in underdeveloped countries such as sub-Saharan Africa and south Asia, and there are a number of initiatives supported by the World Health Organization to reduce these numbers by 2030.

Although numbers are smaller in the UK, there remains a gap between the number of people needing vision correction and those who have their refraction corrected with spectacles, contact lenses or surgery. It is estimated that there are still around 800,000 people in the UK living with sight loss due to uncorrected refractive error (RNIB, 2021).

Our cover story explores the possible reasons behind the barriers to attending an eye examination. While there are some amazing initiatives to bring eye care to disadvantaged groups in this country, more robust data is required to better understand which groups are more likely not to be accessing eye care and have an uncorrected refractive error.

Conflict can impact effectiveness and be detrimental to patient care

With recent census data available online, now is the time to check the make-up of your local population in terms of age, ethnicity and social deprivation. My local sight loss support charity recently carried out this exercise to confirm whether or not their member demographics were representative of the local sight loss population. This was an interesting and important exercise that has given the organisation an up-to-date evidence base to channel its limited resources into the gaps. Check out your practice catchment area.

A gap that will continue to be debated in optics is between NHS remuneration and the true cost of an eye examination. Prescribers need to be mindful of the large difference in cost to the NHS between a generic and a branded drug, and we must balance the need for patient safety and wellbeing with cost. Our article asks if brand is always better.

Keeping to the theme of gaps, chasms – narrow and wide – exist between people. Different viewpoints, opinions and perspectives can result in conflict. In clinical practice, this can impact both team morale and effectiveness and be detrimental to patient care. 

Our article explores conflict in the workplace and experts discuss the creation of an environment where positive conflict could be encouraged for the benefit of the practice team and the patients. It highlights that, without conflict, nothing would change.  

Learning when we need to avoid, accommodate, compromise, compete or (ideally) collaborate to achieve a goal and maintain productive relationships is a skill we can all practise at work and at home!

Jane Veys MSc MCOptom FIACLE

Jane has been involved in optometry for over 30 years and is an experienced educator, facilitator and scientific writer. She has published more than 50 articles, authored a leading contact lens textbook and created industry leading digital education series.

Image credit | Caroline Andrieu


RNIB. (2021) Key statistics about sight loss. (accessed 20 March 2023).

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