By Alexa Kaczka
Millions of people across the UK can have their eyes tested every couple of years to determine whether they need contact lenses or glasses, but certain regions have been traditionally slower than others to take up the offer of vision testing.
One of these is Scotland, which has historically fallen behind England and other nations in the UK when it comes to its citizens' uptake of eye testing, and this continues to be an issue, even since those north of the border have been able to take advantage of free eye care.
A new study by economists from the University of Aberdeen shows that Scotland's policy of free eye care has helped to close the health gap in eye care between those living north and south of the border, but the uptake of optometry services remains low in poorer households.
This means that the wealth divide within Scotland has actually increased, the study authors explain.
Experts from the University's Business School and Health Economics Research Unit have spent 12 months investigating the effect of free eye tests on the utilisation of eye care services in Scotland.
Free examinations funded under the NHS were introduced in the country by the Scottish government in April 2006, with the eye test charge removed to encourage people to make wider use of optometry services.
Prior to the introduction of the policy, fewer people in Scotland were having eye tests than those in other regions in the UK, and as a result, people were expected to benefit from regular eye tests after the changes were made.
It was also predicted that there would be a reduction in waiting times and lists for patients who require referrals to hospital eye services, as more people would be seen in their community, subsequently reducing the risk of late diagnoses and ensuring quicker treatment.
According to lead study author Dr Alexandros Zangelidis, all the evidence pointed to people in Scotland responding positively to the free eyecare policy.
He and his fellow researchers used data from the British Household Panel Survey and business records from a multi-branch private ophthalmic optician company operating in north-east Scotland to assess the uptake of services and whether there were demographic divisions within it.
"The figures from both datasets indicate a rise in the number of people in Scotland having their eyes examined after the introduction of the policy in April 2006," the expert explained.
"Prior to the policy introduction, Scotland had the lowest proportion of its population having an eye test. However, by 2008, the relative difference between Scotland and the other regions had diminished."
Overall, the number of eye tests where patients required no prescription increased by 11.2 per cent from 2006 to 2007, and by 35.6 per cent between 2006 and 2008, while there was also a rise of patients with stable prescription of 11.7 per cent and 30.1 per cent, respectively, over the same time periods.
However, Dr Zangelidis noted that this was not enjoyed equally across all socio-economic groups, which appears to be an ingrained problem.
"Our analysis suggests that people with low education and those from poorer households not only have overall lower levels of eye examinations, but had a weaker response to the policy when compared to highly educated people and those from wealthier households," he explained.
The expert added that, as a result, the inequality in eyecare utilisation north of the border has actually risen.
Study authors now hope that the findings will promote further debate on closing the healthcare gap as far as eyecare is concerned.
From a policy perspective, the findings "clearly indicate" that policy makers should focus on the more vulnerable segments of society in order to alleviate or narrow the inequality, Dr Zangelidis explained.
He suggested that the differences between the educational groups warrant more effort being devoted to informing the public about the free eyecare policy and educating them about the benefits of an eye examination.
by Adrian Galbreth