Our Director of Research, Policy and Innovation Dr Neha Issar-Brown answers questions about the Time to Focus report

Fight for Sight has launched a landmark report called Time to Focus, which clearly demonstrates the rising personal and economic cost of sight loss in the UK.

Dr Neha Issar-Brown is Director of Research, Policy and Innovation at Fight for Sight. Here she answers some questions about the Time to Focus report, which were asked over the course of the launch event, and why the government needs to double its investment in eye research by 2030.

Why was this study needed?

As the only national charity 100% focused on funding pioneering eye research, we are leaders in the fight for stopping sight loss.We therefore brought together sector partners, academics and people with eye conditions to find out how best to catalyse action. Through these discussions it became clear that a more complete picture of sight loss in the UK was needed – covering personal, societal, clinical, healthcare and broader aspects of living with sight impairment or loss. This would enable decision makers to understand the real impact on people’s lives, the true cost of this public health crisis and the potential of research to transform lives. That is why we commissioned this hugely important report.

What were the findings of the report?

Our study has revealed that eye conditions cost the UK economy a staggering £25.2 billion a year - owing mostly to barriers to the workforce for people with sight loss and the need for family and friends to provide informal care. In fact, 84 percent of the total economic costs lie outside of the health and social care system, although the health and social care costs are also vast, equating to 3.9 billion a year, which has worsened during the pandemic.

Shockingly, we found that the quality of life of people with severe sight loss, using the national standard measures, is lower than that of people with a range of other severe physical and mental health conditions, including depression, arthritis and advanced breast cancer.

However, our unique costing tool, which we developed in partnership with the LSE, has shown that reducing the prevalence of eye conditions by just 1 percent per year could avoid costs to the UK economy of up to £3.1 billion by the end of the decade. To do this we need to invest in eye research to find new treatments and cures for the leading causes of sight loss.

Our report gives examples of research successes that have already transformed lives and led to savings - for example, it is estimated for every pound spent in research the return on investment is 25p every year.

What are you recommending?

With an ageing population and sight loss on the increase, we are calling for sight loss and blindness to be treated as one of the major public health issues of our time.

Currently, only 1.5 percent of national research funding is invested in eye research, and sight loss charities invest only 3 percent of their income in research with the vast majority on care and support. There is a chronic imbalance in this regard and the status quo is not good enough. We’re calling for the Government and funding bodies to double spending on eye research by 2030. We are also calling for a national plan on sight loss that addresses research and prevention alongside care and support.

Our new costing tool is open access and we’re encouraging the UK government and other funding bodies, as well as health service commissioners and providers to use it to plan for the future and ensure sight loss research and services are appropriately funded.

How have you arrived at your figures of doubling research investment?

We assessed developments in other areas and discovered that an increase in investment of this scale is possible when the government takes a health condition seriously. As an example, between 2012 and 2015 the UK government doubled investment into dementia medical research and invested the equivalent of £97 per year for every person with dementia. In contrast just £9.60 is currently invested in eye research per year for each person with sight loss.

While doubling investment in eye research would still only take us part of the way, increased investment would transform hundreds of thousands of lives, save the economy money, and keep the UK at the forefront of ophthalmology research.

Our study shows that a focus on investment in new treatments for high-cost and high-prevalence conditions like age-related macular degeneration and diabetic retinopathy – which are currently untreatable in many cases - could have the biggest impact.

Given that a huge amount of resources are needed to focus on the Covid-19 pandemic, is now really the right time to be talking about increasing funding for eye research?

Tackling the pandemic must remain a national priority. However, we believe that the direct impact of the current pandemic makes investment in eye research more important than ever. Our research shows that the lockdown is having a profound impact on people with sight loss and bringing research to a standstill. Our survey has shown that people with sight loss fear their sight has or will further deteriorate during the Covid-19 pandemic, as they struggle to access treatment for their eye conditions. 73 percent of survey respondents reported that their access to treatment had gotten worse during the pandemic and four in ten were concerned that their eyesight has or will further deteriorate as a result. So,apart from the personal cost of the delays due to the lockdown, this is inevitably putting additional pressure on an already overstretched NHS– both now and in the very near future. 

Our point is that we mustn’t lose sight of the bigger picture. Our report shows by investing in research you transform lives and make vast savings, which will take pressure off the NHS  - particularly with ophthalmology representing the highest number of outpatient visits of any specialty and the numbers increasing fast due to an aging population. 

Why is eye research so often overlooked?

One reason is that most people don’t know sight loss can be prevented or cured. They mistakenly think that sight loss equals blindness and is therefore unavoidable and untreatable. This lack of awareness of the causes and treatments of sight loss is robbing people of their vision and quality of life. This report demonstrates that the quality of life of people with severe sight loss, using the national standard measures, is lower than that of people with a range of other severe physical and mental health conditions, including depression, arthritis and advanced breast cancer. Despite that, with the current attitudes towards and lack of awareness that sight-loss can be preventable it is unsurprising that it is often overlooked in the Government, health-care and policy circles, which then translates to even less focus in investment to prevent and treat sight loss.

How can we address preventable sight loss?

Our report has shown how much we could transform lives and save money by reducing prevalence; it also outlines the huge numbers of avoidable cases of sight loss - it is estimated that more than a million people in the UK are living with avoidable sight loss. Across the sector we need to work together to achieve this, through both prevention campaigns that promote good eye health and regular eye tests, as well as through investment in research for early diagnoses, detection, and ultimately tofind new treatments.

One of your recommendations is for eye charities to spend more of their income on eye research. Given that many frontline sight loss charities have a relatively small income compared to funding bodies, what impact can be made, compared to the impact of the support they provide to blind and partially-sighted people?

We are absolutely not trying to pit care and support services against medical research and we don’t see this as a zero sum game. Having the right care and support for people with sight loss is vital, but we are making the case for increasing the size of the overall pot and tipping the scales towards investment in sight loss research, so we can find solutions to the conditions and not simply manage them. Our report shows only three percent of income from all sight loss charities is invested in research and we believe this needs to change. Previous data has shown that for every pound invested in research there is an overall return on investment of 25p every single year in future.

What is the best way for sight loss charities to collaborate?  

We hope that this report is the start of a conversation - we have worked with partner charities in producing the report and will continue to work with the sector to achieve our report recommendations of increasing charity collaboration, research funding and prevention or sight loss.

What will you do with this report and how will it help with influencing change?

We will be using this report to lobby decision-makers, funding bodies and other stakeholders to deliver on our key recommendations. We are calling on the government to double public investment in sight loss research by 2030. We are recommending that sight loss charities invest more income in eye research – the current 3 percent spend is simply not enough. We want the sight loss research sector, including funders and the pharmaceutical industry, to commit investment, collaborate more and scale up. This would enable the discovery of new ways to diagnose more eye conditions early and target new treatments that stop the progression of eye conditions and restore people’s sight.

The next step will be meeting with government representatives and other stakeholders to influence policy change, ensure that the growing national health crisis of sight loss is being taken seriously and achieve our goals in the next decade.