By Richard Spruce, Vice Chair at Optometry Scotland
Published in The Times on the 9th of February 2026 (Print only)
Low vision affects over 180,000 people across Scotland, and that figure is expected to double by 2031. For many, sight loss erodes their ability to read, travel, work or manage everyday tasks. While these conditions are often irreversible, the right support can be life-changing.
NHS ophthalmology services are under sustained pressure. It is one of the busiest outpatient specialties, with more than 600,000 appointments delivered last year and a backlog exceeding 35,000. Political parties increasingly recognise that care must move closer to communities. Scottish Labour’s 2024 manifesto, for example, committed to “deliver long-term reforms to modernise services and bring care closer to communities.”
Expanding Community Low Vision Services (CLVS) is a pragmatic, cost-effective step that would benefit patients while easing pressure on hospitals. Scotland already has a world-leading community optometry model that is comprehensive, accessible and free at the point of use. With the right backing, low vision care delivered locally could significantly improve outcomes.
Yet provision remains inconsistent. In some health boards, services are still hospital-based, requiring vulnerable patients to travel long distances or face lengthy waits. Elsewhere, support is patchy and overstretched, creating inequity at a time when vision loss is rising.
Patients consistently report that they prefer to be seen locally, by someone they know. Community optometrists and dispensing opticians already provide continuity and familiarity. The challenge is reshaping the system so low vision support is available close to home, without unnecessary hospital referrals.
A national CLVS would build on existing strengths. Delivered through local practices, it would offer assessments, magnifiers and digital devices, training to use aids effectively and tailored guidance to help people maintain independence. Dispensing opticians play a central role through their expertise in advising on these optical appliances and providing ongoing patient support.
A recent case from one of Optometry Scotland’s (OS) members illustrates the impact this can have. A patient with worsening dry macular degeneration had stopped attending football matches because he could no longer see the scores. Conventional lenses offered no improvement. Through the Ayrshire and Arran Low Vision scheme, he trialled a handheld telescope that restored his ability to follow the game. At review, he described the device as “life-changing.” Without local provision, he may have been told that nothing more could be done.
This type of support does more than transform individual lives. It also frees up hospital clinics to focus on other pressures, such as cataract waiting lists, while reducing delays and improving patient experience. The infrastructure already exists, with more than 2.4 million NHS-funded eye examinations delivered annually in Scotland. The Community Glaucoma Service, for example, is expected to manage up to 20,000 patients once fully rolled out.
OS’ manifesto calls for a national CLVS. From 2028, all newly qualified optometrists will be Independent Prescribers, further strengthening community capacity. With proper investment, Scotland can deliver a world-leading model of eye care that transforms lives while strengthening the NHS.