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- Primary eye care in Wales provides more than 1.56 million appointments each year, including sight tests, enhanced eye care services and contact lens care appointments [1]
- Secondary care provides 322,000 appointments each year [2]
NHS primary eye care services in Wales were transformed following legislative change in 2023, with Wales General Ophthalmic Services (WGOS) replacing General Ophthalmic Services (Wales) (GOS[W]), Eye Health Examination Wales (EHEW), Low Vision Services Wales (LVSW), and other locally commissioned enhanced service pathways.
WGOS has five levels
- WGOS 1 - sight test service
- WGOS 2 - enhanced eye care services
- WGOS 3 - low vision assessment
- WGOS 4 - referral refinement and monitoring
- WGOS 5 - independent prescribing
There is also a WGOS mobile service that can provide WGOS 1 to WGOS 5.
WGOS 1 and WGOS 2 must be provided by all providers. Providers can opt to provide WGOS 3, 4 and 5.
NHS Wales sets out who is eligible for an NHS-funded eye examination and help towards the cost of prescription glasses.
Seven Local Health Boards in Wales also provide a Hospital Eye Service (HES).
FODO members provide most primary eye care services in Wales and FODO works closely with Optometry Wales to advance eye health and eye care across the whole of Wales.
Optometrists and dispensing opticians comprise the largest regulated workforce in eye care, followed by ophthalmologists and orthoptists.*
Primary care optometrists are also qualified to manage a large and complex caseload. The table below provides an overview of the competencies and qualifications of primary care optometrists.
The section below provides an overview of eye health professionals and how they are regulated.
Regulated by the General Optical Council. Optometrists perform detailed eye examinations to detect defects in vision, ocular disease or other health issues. Many now also perform advanced diagnostic tests and co-manage patients with eye conditions. They form the single largest group of eye care professionals in the UK.
Dispensing opticians
Regulated by the General Optical Council. Dispensing opticians can fit and supply spectacles to children and adults and can advise on and dispense low vision aids. With additional specialist training they can also fit contact lenses and examine the anterior eye for defects and ocular disease.
Orthoptists
Regulated by the Health and Care Professions Council. Orthoptists specialise in diagnosing and treating visual problems involving eye movements. They might have other roles and responsibilities. They typically work in hospital eye clinics but can also work in community settings - for example, when screening in schools.
Ophthalmologists
Regulated by the General Medical Council. Ophthalmologists are medically trained doctors who specialise in eye health. They often do a mix of surgical and non-surgical work, and as they build more experience they typically specialise in a specific sub-speciality, with Health Education England noting eight subspecialty areas in 2019
- Cornea and anterior segment
- Medical retina
- Glaucoma
- Oculoplastic surgery (plastic surgery around the eye)
- Paediatric ophthalmology
- Surgical retina (vitreo-retinal surgeons)
- Primary care
- Medical and neuro-ophthalmology.
References
[1] FODO, The future of primary eye care - principles and priorities https://www.fodo.com/flipbooks/FODO-Strategy-Document-Full-2023/. Each year practices in Wales provide more than 1.148 million sight tests, at least 201,000 enhanced eye care appointments and an estimated 200,000 contact less appointments (based on 5% of contact lens users in the UK living in Wales and visiting at least once per year). Excluding visits for repeat tests and advanced diagnostics, a conservative estimate is that 1.56 million clinical appointments are offered each year.
[2] FODO, The future of primary eye care - principles and priorities https://www.fodo.com/flipbooks/FODO-Strategy-Document-Full-2023/.
*This shows the current split of the workforce within the UK.
