Optometry Scotland warns of “postcode lottery”
Optometry Scotland (OS), the representative body for optical professionals, has published a landmark report calling for the full integration of an early diagnostic tool in primary eye care across Scotland.
Optical Coherence Tomography (OCT) is a non-invasive imaging technique that uses light to create high-resolution, cross-sectional images of tissues, often used in ophthalmology to examine the retina and optic nerve.
The report, informed by an OS Short Life Working Group (SLWG) on OCT, outlines the transformative role this diagnostic technology plays in the early detection of eye conditions such as glaucoma, diabetic retinopathy and macular degeneration.
A survey conducted as part of the SLWG investigation found that 80% of optometry practices are already using OCT, but that there were regional and demographic inequalities to access. The report calls for urgent government actions to address inequalities in access and reduce pressure on secondary care services.
Currently, OCT is not funded through General Ophthalmic Services (GOS), resulting in a postcode lottery where patients in affluent areas are more likely to benefit from early diagnosis and treatment.
The report warns that this disparity risks exacerbating health inequalities and overwhelming hospital-based ophthalmology clinics.
The report recommends introducing an enhanced GOS fee for OCT scans in acute eye presentations, alongside a national capital funding programme to support practice investment in OCT equipment. The group also advocates for long-term support for ongoing maintenance and secure data storage.
OS’ survey of practices informed the report’s findings, revealing strong support among optometrists for incorporating OCT into NHS-funded services.
Cost remains the most significant barrier to universal access, particularly in deprived areas where ocular disease prevalence is higher and patients are less likely to be able to pay for private scans.
The report also highlights the wider benefits of OCT integration, including reduced hospital admissions, improved referral accuracy and enhanced training and development for practitioners.
With secondary care waiting lists at record highs and an aging population on the rise, the report concludes that expanding community-based OCT use is key to delivering timely, preventative eye care.
Julie Mosgrove, chair of the SLWG, said: “OCT is already changing lives, but only for those who can afford it. This report shines a light on the growing gap in access to essential diagnostic services and makes clear recommendations to address it. If we are serious about tackling health inequalities and building a sustainable healthcare system, we must make sure there is equitable access to this technology across all communities in Scotland.
“The evidence is clear: investing in OCT at a national level will enhance patient outcomes, support clinical decision-making and ease the burden on our overstretched hospital services. This is a crucial investment in both technology and the future of eye care.”
The report has been submitted to the Scottish Government for consideration.
The OCT report is available to read in full on the OS website at: https://optometryscotland.org.uk/publications/