Skip to content

Primary Eye-care Acute Referral Scheme

Two weeks ago, towards the end of the first equipment trial, I started getting weird blue flashes in the corner of my left eye, accompanied by very blurred vision. At first, I thought it was the onset of another migraine – I’ve been getting a steady stream of them recently – but the pain never materialised, and the vision problems didn’t really settle down. Unusual. This Monday I happened to be in town directly opposite my opticians when I was getting my hair cut, so I thought I’d better pop in and see whether I was due for an eye test soon, and if not whether they would bring it forward.

To my surprise, they said that they didn’t think it was appropriate to bring forward my scheduled test, but instead offered me an emergency appointment later that day under the PEARS system – Primary Eye-care Acute Referral Scheme. However, they told me that the tests they wanted to do on me involved putting dilating drops into my eyes, so I’d be unable to drive afterwards. That didn’t suit me, as I had plenty of plans for the day, all of which involved driving home. So I negotiated an appointment for Wednesday morning, which gave me time to organise a taxi, but which the opticians weren’t particularly happy about. They wanted to make it clear that they’d done their duty by offering me a PEARS appointment within 24 hours, and on my head be it if I insisted on a later date. I pointed out that I’d been putting up with disturbed vision for nearly a fortnight by then, and was happy to take the risk.

On Wednesday I got a taxi into Malvern for the appointment, and chatted to the optician while I was waiting for the eye-drops to take effect. Apparently, PEARS is a fairly new initiative by the NHS, originally designed to save them money, but one that really seems to be a win-win. Each PEARS appointment at a local optician costs the NHS approximately £40, compared with £120 for a hospital appointment. Patients can either be referred to their optician by their GP, or can self-refer by walking in off the street as I did. Approximately two-thirds of patient can have their cases satisfactorily resolved at the opticians, which is much quicker and more convenient for them than having to make a trip to hospital. Those that do have to be referred onwards to a hospital consultant benefit from less demand for those appointments, and hence a quicker overall response time. And the hospital benefits from having eye-care professionals providing a triage service for them, so get fewer trivial cases cluttering up their surgeries.

Unfortunately, although my optician could find nothing wrong with my eyes other than “floaters”, she couldn’t rule out a retinal tear. Because I am extremely short-sighted, I’m at much increased risk of those compared to the wider population, and so I was one of the one-third who get referred on to a follow-up hospital appointment. I got a taxi back from the opticians on Wednesday lunchtime, and as I put my key in the lock I could hear the phone ringing. It was a hospital nurse saying they wanted to see me straight after lunch on Friday, and that I’d be unable to drive afterwards.

I was seriously unhappy about this development. Firstly, the appointment was at Kidderminster Hospital, which is very inconveniently a good hour north of me, but more seriously a place that gives me the screaming ab-dabs to even think about. It was there that Christopher was first given the news that he had oesophageal cancer, I went into deep shock sitting on the seats in the Reception area, and things went downhill from there. Secondly, I have a long-standing and deep-seated phobia about anything to do with eyes, and medical procedures to do with them massively freak me out. So all in all, an appointment at the Ophthalmology department of Kidderminster Hospital is the stuff of nightmares.

Nevertheless, there was no point ignoring the possibility that there was something wrong. So I phoned my trusty taxi company, whom I use regularly, and arranged for a driver to pick me up from home on Friday lunchtime, drive me to Kidderminster Hospital, wait for me there for however long the appointment took, and drive me home again afterwards. They were very accommodating, and it turned out that the reason for that was that the elderly chap who is my regular taxi driver was recovering from a detached retina, and had been treated at Kidderminster himself. I’m not sure I’m happy at the thought of a taxi driver with a detached retina!

Fortunately, it all went very well. The consultant was very understanding with my phobia. I managed to allow her to do most of the examination, which was enough for her to be confident that I didn’t have a retinal tear, or any other major problems, and I was discharged with a clean bill of health. I was however told that if it happened again I wasn’t to wait two weeks before seeking help, but to go to my opticians as a matter of urgency.

My pupils were so massively dilated from the eye drops they’d used, and the day was so sunny, that the drive home was pretty unpleasant and I spent most of the time with my eyes tightly closed. I wished I’d had the foresight to take some dark sunglasses with me! I spent the rest of the afternoon and evening at home, sitting in the semi-darkness in my living room with the curtains drawn, peering at the tennis on the TV and waiting for my vision to return to normal. That’s not how I would have chosen to spend the last day of my weeks leave! But at least I can be reassured there’s nothing seriously wrong, I’m still safe to drive, and the floaters in my vision are nothing to worry about.

{ 1 } Comments

  1. pauld | 8 July 2013 at 6:36 pm | Permalink

    Oh i got floaters in one eye, a pretty rare form, i’m unique !!!, optician was actually thrilled that she’d identified the type she sent letter to tell Dr. Dr on other hand couldnt be arsed to do anything and just filed it.

    You could of course use the indicent and words like ‘stress induced’ to try to panic your management for a laugh