The past 12 months have been anything but ordinary. COVID-19 restrictions have impacted access to eye care across Australia, with prolonged lockdowns restricting optometrists from providing routine care. Assessment of the FY 2020/21 Medicare data helps us understand just how much of an impact the past 12 months has had on patient care.
As a key diagnostic tool in detecting glaucoma and neurological disorders that affect visual pathways, analysing utilisation of Medicare codes 10940 and 10941 for visual fields helps draw inferences on the level of detection and management of glaucoma in the community.
The FY 2020/21 Medicare data highlights a continued impact on primary eye care services since the previous year, however taking into account the heavy impact on optometry services last year due to COVID-19 restrictions, this year’s utilisation has surpassed two years ago, demonstrating that access to care, particularly for those patients with conditions such as glaucoma, is key.
Specsavers Director of Optometry Dr Ben Ashby says, “For the past five years, Specsavers has been spearheading a dedicated campaign to reduce the levels of undiagnosed glaucoma, a preventable blindness eye condition. Performing an OCT as standard for every patient, and in conjunction utilising visual field tests for those patients where indication is identified, along with increased professional education for all optometrists have been integral elements in our approach to detecting glaucoma.
“We have already seen massive in-roads in reducing the seemingly accepted statistic that 50% of all glaucoma goes undiagnosed by building consistency in visual field utilisation for glaucoma suspects. Therefore, it is pleasing to see a return to positive trends in visual field use over the last 12 months across all eye health providers. However, while more glaucoma patients were able to continue accessing care during COVID-19 restrictions this year, there will still be a large cohort of ‘missed’ patients, therefore accessibility to clinics and supporting our communities while actively following up with overdue glaucoma patients after lockdowns is key.
“As optometrists, early detection and management of glaucoma in the community is not only vital to avoiding vision loss in thousands of Australians, but it helps to reduce the long-term impact on public health in the future. We have a great responsibility to utilise Medicare funding wisely, and the data is already showing that by conducting visual fields on those patients suspected of glaucoma, we are detecting and referring 1.43% of our patients, a rate close to the 1.5% prevalence of glaucoma in the Australian population.”
Medicare data also highlights a consistent use of code 10915 – comprehensive diabetes examination – over the last 12 months. Again, accounting for COVID-19 restrictions, it is positive to see those patients with diabetes able to access care at enhanced levels to two years ago. This continues to highlight the importance of access to primary eye care.
Diabetes remains the leading cause of avoidable blindness in working aged Australians. Which is why two years ago Specsavers joined as a founding and funding partner of KeepSight. Led by Diabetes Australia, this national reminder program – a ‘once in a generation’ opportunity to significantly reduce diabetes-related vision loss across Australia – focuses on proactive, targeted patient communications and reminders to encourage people with diabetes to have timely diabetes eye checks to prevent risk of vision loss due to their condition.
Specsavers attendance data for people with diabetes demonstrates the impact KeepSight is beginning to have on encouraging patients with diabetes in for regular eye checks. It is anticipated this trend will continue upwards over the coming three years.
At its launch in 2019, Specsavers aimed to register 200,000 patients to KeepSight in the first two years. Pleasingly, that number was surpassed in 2021, with many patients also now realising the benefit of the reminders – Specsavers is seeing more patients with diabetes return for care within recommended timeframes.
New signs and symptoms and progressive disorder
Continuing the theme of accessibility to primary eye care, there has been an increase in use of the following codes for patients across all eye health providers: 10912 – significant change of visual functions; 10913 – new signs and symptoms; and 10914 – progressive disorder requiring reassessment.
The significant use of all codes (NB. 10912 and 10913 are restricted to existing patients of a practice), demonstrates that even during COVID-19 lockdowns and restrictions, many optometrists continue to provide access to those with symptoms and a functional impact to their vision.
With many practices closed or only open for essential care for a period of time over the past 12 months, this data highlights the pressing need to ensure there is continued access to optometry services so those patients with concerns can be reassured and treated accordingly.
In addition, the 16% increase in the use of 10914 speaks to Australia’s aging population. 10914 encompasses patients with glaucoma, AMD and cataracts, all conditions that have a strong correlation between age and prevalence.