The barriers and facilitators to primary care optometrists supporting patients with low vision in England

Research suggests that patients with low vision identify optometrists as their core eye care provider within the community; hence, optometrists are well placed to provide support, advice and potentially certify patients. A qualitative study was conducted to ascertain the barriers and facilitators to primary care optometrists supporting patients with low vision.

An online questionnaire used open-ended questions to investigate optometrists' knowledge of the Certification of Vision Impairment and registration processes, and the barriers they faced when providing support to patients with low vision. Unmet training needs on low vision and whether optometrists would be happy to certify patients were also explored; data were analysed using deductive thematic analysis.

A total of 148 questionnaires were completed by optometrists in England between October 2023 and January 2024. Varying levels of knowledge were found regarding the certification and registration process. Three barrier-related themes were identified. These were system barriers, practitioner barriers and patient barriers. Four themes were identified related to facilitators to supporting patients with low vision. These were training methods, training needs, low vision pathway, including optometrists' ability to certify patients and communication between services.

With appropriate remuneration, optometrists reported positively with regard to upskilling and extending their scope of practice to ensure the best care for patients. Optometrists were found to be happy to certify patients if appropriate training and remuneration were received. This would involve the development of a funded Low Vision Pathway in England. Optometrists would benefit from further Continuing Professional Development training with elements from local Eye Clinic Liaison Officers, low vision practitioners and the Hospital Eye Service to improve knowledge around the certification and registration process and local support services available.