Ophthalmic Public Health Group
Our multidisciplinary group undertake public health research related to the quality and safety of eye care.
Our high quality research has a direct impact on individuals accessing and delivering eye care services, mainly in primary care, with respect to the improvement of health and eye care quality and safety.
The scope of our research includes, but is not limited to, service evaluations, interrogating large datasets and seeking the perspectives of patients, carers, health care staff and organisational management, using mixed methods.
Our primary aim is to plan and implement public health research related to eye care. The specific aims include:
- Widening our network to work with collaborators from others in Cardiff University and externally.
- Supporting strategic oversight of the research underpinning the development of the eye care pathways in Wales.
- Work directly with NHS staff and patients in order to develop exemplars for practice improvement through partnered working.
- Undertaking engagement activities to gain feedback from patients and the public on our research and to disseminate our findings.
- Undertaking knowledge transfer activities in the form of problem identification workshops, involving clinicians and NHS representatives.
- Engaging with the third sector and other organisations with the purpose of policy influencing, consistent with the development of high quality impact cases.
Developing areas of research include:
- Evaluations of the transition from hospital care to primary care.
- Evaluations of non-medical healthcare professional co-management and virtual clinics.
- Use of electronic medical records (EMRs) and database construction.
- Artificial intelligence innovations in streamlining care pathways.
- Selection of appropriate measures from a patient perspective.
- The education of healthcare professionals.
- Development of multilevel care pathways.
- Use of technology and other interventions to support rehabilitative strategies in individuals with vision impairment.
- Patient safety in eye care.
- Depression screening in eye care.
- Health economic studies relating to eye care services.
A preventative approach for Access to a Sustainable, whole System pathway for older people with vISion impairmenT (ASSIST)
The project will address the need for more sustainable care and support for older people with vision impairment to help them live happier and more fulfilling lives. The problem for many older people with vision impairment can be getting access to and finding the right type of support for their individual needs. Social Prescribing means “connecting people to community support to better manage their health and wellbeing”, in which professionals (e.g. doctors, optometrists, social workers, housing officers) can refer people to community services and activities.
The project aims to find out what the current provision of care and support for older people with vision impairment is, to uncover gaps in access and identify areas of best practice. We will recommend how improvements can be made to support better, joined up working and more efficient ways of using existing resources. The project will involve mixed methods, using a realist approach to hear the views of individuals with vision impairment and their carers, as well as staff and other stakeholders. The project is led by Dr Jennifer Acton, with research team members at Swansea University and University of South Wales and the funder is HCRW.
Evaluation of errors in the delivery of care to patients with eye-related problems
Funded by KESS2 East, this project aims to evaluate errors in the delivery of care to patients with eye-related problems.
Key aspects of the project:
- Development and testing of a patient safety incident reporting system for optometry in Wales.
- Mixed methods analysis of patient safety incident reports describing unsafe eye care in England and Wales.
- Stakeholder consensus on the nature of avoidable unsafe eye care.
You can view the supporting guidance for optometrists reporting serious incidents on this document.
The Principal Investigator for the project is Dr Jennifer Acton and the Co-Investigator is Andy Carson-Stevens.
Hospital to Community
Hospital to Community aims to identify the value of optometrists monitoring & managing chronic sight threatening eye disease in primary care. It is an evaluation of the potential patient benefit & value of enhanced optometry services, provided by primary care-based optometrists rather than the hospital eye service, of managing and monitoring people with the sight threatening & chronic conditions wet macular degeneration or glaucoma. A longer term goal is to further analyse a patient reported experience measure, in order to develop an instrument suitable to embed into clinical practice. The Principal Investigator is Professor Barbara Ryan.
Acute Eye Care Project
The Acute Eye Care project is a collaboration with SAIL (Secure Anonymised Information Linkage) and is an evaluation of outcomes from individuals receiving care for acute eye conditions from different healthcare services. The project is a Wales-wide data analysis of prescribing for acute eye conditions. The Principal Investigator is Dr Jennifer Acton.
Independent prescribing in optometry
In collaboration with Prof Molly Courtenay (HCARE), Angela Whitaker and researchers from the University of Bedfordshire and Bristol Medical School, we recently undertook a qualitative study on the factors affecting prescribing by independent prescriber optometrists, based on the Theoretical Domains Framework.
In ongoing work in collaboration with Dr Nik Sheen from HEIW we are evaluating an intervention to support newly qualified independent prescriber optometrists.
Investigation of pain and discomfort associated with anti-VEGF injections
Led by Dr Ashley Wood, and funded by Abbeyfield Research Foundation, we are using mixed methods research to evaluate the experience of pain in patients undergoing anti-VEGF injections for AMD.
Service evaluation of the Aneurin Bevan Health Board Wet Age-related Macular Degeneration Referral Refinement service
This project aims to evaluate the Ophthalmic Diagnostic and Treatment Centre (ODTC) in Specsavers Austin Friars Newport as part of an MSc Project by Bethan Pugh. It will evaluate of the referral refinement service in the context of capacity, waiting times and patient feedback. Project supervisors are Barbara Ryan and Rachel North.
Primary care Optometric Referral Refinement & Monitoring for Wet Age-related Macular Degeneration
This project is an overall evaluation of Stakeholder Experience in Wales KESS 2 East Wales MRes. Principal Investigators are Mark Davies and Sharon Beatty.
Transforming Eye Care Services Wales
This project aims to evaluate the enhanced eye care services delivered by optometrists in primary care, using patient reported experience measures (PREM). As part of the project, the initial development of the PREM will include a preliminary validation using outcomes from different areas across the service. The project is funded as part of the Accelerate scheme, supported by the Welsh European Funding Office (WEFO). Lead researchers on the project are Dr Angharad Hobby, Dr Jennifer Acton and Prof Barbara Ryan. The PREM validation is being undertaken in collaboration with Swansea University (Prof Deborah Fitzsimmons, Dr Pippa Anderson, Dr Mari Jones).
Meet the team
- Rawlings, A. et al., 2023. The burden of acute eye conditions on different healthcare providers: a retrospective population-based study. British Journal of General Practice (10.3399/BJGP.2022.0616)
- Evans, L. et al. 2023. An operations research approach to automated patient scheduling for eye care using a multi-criteria decision support tool. Scientific Reports 13 553. (10.1038/s41598-022-26755-1)
- Cottrell, P. et al. 2022. Optometry independent prescribing during COVID lockdown in Wales. Ophthalmic and Physiological Optics 42 (6), pp.1289-1303. (10.1111/opo.13028)
- Karas, M. et al. 2022. An analysis of glaucoma repeat measures assessment results: Are core competencies enough?. Ophthalmic and Physiological Optics 42 (6), pp.1147-1158. (10.1111/opo.13032)
- MacFarlane, E. et al. 2022. A mixed-methods characterisation of patient safety incidents by primary eye care practitioners. Ophthalmic and Physiological Optics 42 (6), pp.1304-1315. (10.1111/opo.13030)
- Shah, R. et al., 2022. Referrals from community optometrists to the hospital eye service in Scotland and England. Eye 36 , pp.1754-1760. (10.1038/s41433-021-01728-2)
- Acton, J. H. et al. 2021. Response to Comment on: Agreement between optometrists and ophthalmologists in the certification for vision impairment. Eye 35 , pp.2325-2326. (10.1038/s41433-020-01143-z)
- Bartlett, R. et al. 2021. Training results in increased practitioner confidence and identification of depression in people with low vision: a mixed methods study. Ophthalmic and Physiological Optics 41 (2), pp.316-330. (10.1111/opo.12788)
- Spillane, D. et al., 2021. Factors influencing the prescribing behaviour of independent prescriber optometrists: a qualitative study using the Theoretical Domains framework. Ophthalmic and Physiological Optics 41 (2), pp.301-315. (10.1111/opo.12782)
- Bartlett, R. et al. 2021. Agreement between ophthalmologists and optometrists in the certification of vision impairment. Eye 35 , pp.433-440. (10.1038/s41433-020-0860-x)
- Nollett, C. et al. 2020. Barriers to integrating routine depression screening into community low vision rehabilitation services: a mixed methods study. BMC Psychiatry 20 , pp.419. (10.1186/s12888-020-02805-8)
- Karas, M. et al. 2020. Continuing professional development requirements for UK health professionals: a scoping review. BMJ Open 10 (3) e032781. (10.1136/bmjopen-2019-032781)
- Nollett, C. et al. 2019. How do community-based eye care practitioners approach depression in patients with low vision? A mixed methods study. BMC Psychiatry 19 (1) 426. (10.1186/s12888-019-2387-x)
- North, R. et al. 2019. Wet Age Related Macular Degeneration services in the community: A pathfinder evaluation - Final Report. Project Report.Cardiff: Cardiff University
- Thomas, R. L. et al., 2017. Retrospective analysis of newly recorded certifications of visual impairment due to diabetic retinopathy in Wales during 2007-2015. BMJ Open 7 (7) e015024. (10.1136/bmjopen-2016-015024)
- Acton, J. H. et al. 2016. Effect of a home visit-based low vision rehabilitation intervention on visual function outcomes: an exploratory randomized controlled trial. Investigative Ophthalmology & Visual Science 57 (15), pp.6662-6667. (10.1167/iovs.16-19901)
- Thomas, R. L. et al., 2015. Prevalence of diabetic retinopathy within a national diabetic retinopathy screening service. British Journal of Ophthalmology 99 , pp.64-68. (10.1136/bjophthalmol-2013-304017)
- Woodhouse, J. M. et al. 2014. Ocular and visual status among children in special schools in Wales: the burden of unrecognised visual impairment.. Archives of Disease in Childhood 99 (6), pp.500-504. (10.1136/archdischild-2013-304866)
- Ryan, B. et al. 2013. Effectiveness of the community-based Low Vision Service Wales: A long-term outcome study. British Journal of Ophthalmology 97 (4), pp.487-491. (10.1136/bjophthalmol-2012-302416)
- Thomas, R. L. et al. 2012. Incidence of diabetic retinopathy in people with type 2 diabetes mellitus attending the Diabetic Retinopathy Screening Service for Wales: retrospective analysis. BMJ 344 e874. (10.1136/bmj.e874)
Find out more about our research
Our research delivers advances in knowledge to facilitate detection, diagnosis, monitoring and treatment of vision disorders to improve quality of life.