A global view of eye health

Professor Peter Shah and Professor Alastair Denniston

A team led by two consultant eye surgeons from University Hospitals Birmingham NHS Foundation Trust (UHB), Professor Alastair  Denniston and Professor Peter Shah, has recently completed the largest ever review of the impact of social deprivation on eye health across the globe.

Overall, the findings highlight how poverty, lack of education and social disadvantage, contribute to blindness around the world.

Professor Denniston said: “This was a mammoth task. The team identified nearly 5,500 papers that had to be hand-sifted to extract any relevant data. We eventually narrowed it down to just over 200 really important studies in this area, covering most parts of the globe, and generally focussed on the commoner eye conditions such as cataract, glaucoma and diabetic eye disease.”

At 92 pages, the report is the most detailed analysis of this area of work. By examining the worldwide literature looking at social deprivation and eye care, the research team showed the same themes and barriers to care were replicated across the globe.

“The final report is testament to the team’s dedication. It is a really important study because it identifies the extent of the problem here. The people who most need help for sight-threatening eye diseases, are those who are least able to access it,” said Professor Denniston.

The team highlighted how complex the interaction between deprivation and poor eye health can be. For example, just making a treatment free is often not enough. People often face many other barriers such as not understanding their eye problem, fear and suspicion of professionals, difficulties in travel, loss of earnings or lack of a carer to help them get to the treatment amongst many other factors.

Professor Pete Shah agreed with the findings, adding: “I’ve been committed to improving eye health in disadvantaged communities throughout my career. I’ve lead a team of ophthalmologists linking up with Moshi, a municipality in Tanzania to create an International Sandwich Glaucoma Fellowship Program and have found this work incredibly rewarding.

“We have also just completed recruitment to a randomised controlled trial of medical therapy vs laser treatment of glaucoma in Tanzania, with Dr Heiko Philippin as Chief Investigator. Heiko, based in Tanzania, completed his Fellowship with me across two continents and I now act as his long-term mentor and we have become firm friends.”

Looking closer to home, Professor Shah added: “Our team has also undertaken several studies showing how social deprivation impacts on eye health in the UK, but the work with Professor Denniston shows for the first time the extent to which many of these barriers are common to people all over the world. Our hope is that this will now help guide leaders in healthcare to break down the barriers to improve care of potentially blinding eye diseases world-wide.”