Age-related Macular Degeneration: NHS Funding

Debate between Marsha De Cordova and Bambos Charalambous

Tuesday 9th April 2019 Westminster Hall

[Bambos Charalambous (Enfield, Southgate) (Lab)]

I beg to move,

That this House has considered NHS funding for age-related macular degeneration.

I begin by welcoming the Minister to her place. I am very pleased that she is now a Minister and I look forward to having many more interactions with her.

Sight is a wonderful gift. Sight allows us to witness and experience the world we live in. It is not surprising that, in survey after survey, the fear of losing one’s sight comes top in comparison with other conditions. It is remarkable that we do not hear more about the leading cause of blindness in adults, which is age-related macular degeneration or AMD for short.

AMD is the breaking down of the macula, which is the sensitive and small tissue at the centre of the retina. It is responsible for processing central vision and allows us to see colour, detail and sharpness in objects. There are two types of AMD: dry and wet. Dry AMD, which affects 90% of people with the condition, is caused by thinning of the under-layer of the macula, which can lead to blurred vision. Thinning of the under-layer of the macula is caused by small white or yellow deposits called drusen. They may at first not affect vision all that much, but as they build up over time, they can lead to blind spots in someone’s central vision and can later become wet AMD.

Wet AMD is usually caused by new blood vessels growing underneath the macula that bleed and leak into the macula, which can cause blindness and distort vision in that eye. The onset of wet AMD is more rapid and can be more damaging, leading to irreversible vision loss. According to the charity Fight for Sight, AMD is the leading cause of sight loss in the UK, predominantly affecting people aged over 65. It accounts for 50% of severe sight impairment and 52% of all Certificate of Vision Impairment registrations in England and Wales.

AMD progressively damages a person’s central vision, which in some cases can leave them unable to read, drive or recognise faces, although they may retain their peripheral vision. It is estimated that 600,000 people in the United Kingdom are living with late-stage AMD. Industry data suggest that by 2026 there will be 9.7 million people in the UK affected by all stages of AMD and 800,000 of them will have late-stage disease that affects their vision. Projections suggest that by 2050 the figure for people with late-stage AMD could rise to 1.3 million unless measures are taken now to address this issue.

[Marsha De Cordova (Battersea) (Lab)]

I congratulate my hon. Friend on securing this very important debate and I, too, welcome the Minister to her place. Significant numbers of people will potentially lose their sight. My hon. Friend has cited some of the figures. By 2050, the number of people living with sight loss will be in excess of 4 million. Does my hon. Friend agree that, given the numbers, it is time that we had a UK-wide vision strategy on eye health and sight loss?

--- Later in debate ---

[Bambos Charalambous]

The hon. Gentleman makes an excellent point. We should all visit opticians on a regular basis, because they can detect a whole series of other eye conditions.

My second ask is for the publication of a workforce development plan for ophthalmology. That should also be a priority. There is already a shortage of eye care specialists who can diagnose and treat AMD. The number of ophthalmologists in the UK is the second lowest in Europe. The numbers are expected to reduce further, while the patient population is likely to increase significantly. The Department of Health and Social Care should commit to producing a workforce development plan that addresses the current situation and assesses future demand and provision need.

NHS RightCare should also develop guidance and a workstream for AMD, and data packs that can be shared as a resource and inform improvement in treatment for AMD. An IT platform that allows better integration of services is needed—for example, from primary care to hospital-based ophthalmology—so that a more joined-up approach can lead to better outcomes for patients with AMD.

Finally, it should be remembered that there is a link between sight loss and mental health, depression and frailty. The secondary effects of sight loss should also be considered when making both national and local policies on commissioning services.

[Marsha De Cordova]

My hon. Friend is being very generous. On that point about the impact of sight loss and the link to mental health, does he agree that a clear strategy would enable all services to be more joined up, so that when somebody is diagnosed with losing their sight all the relevant support would fall into place because there is a clear pathway?

[Bambos Charalambous]

My hon. Friend makes an excellent point. The impact of sight loss can lead to depression and other mental health issues, so they should form part of any strategy related to sight loss. I agree with her 100%.

I ask the Minister to recognise the need for more attention to the needs of people with AMD, and to set about taking on board and implementing the suggestions that I have raised.