Will I have vision next year?

Over the last twenty years, specialist eye care in Wales has advanced significantly, yet resources have not kept pace with growing demand, according to experts. A new report from a political committee highlights that more than 80,000 patients at highest risk of permanent vision loss are waiting excessively long for critical treatment.

Kristian Shearan shared his personal struggle, explaining that staffing shortages and limited funding delayed treatment that could have slowed his vision deterioration. "Its stressful worrying about what my sight will be like next year," he said.

The Welsh government acknowledged the report, noting that they are reviewing its recommendations and "will respond formally in due course."

Shearan, 50, from Bridgend, has a rare genetic eye condition that has worsened over 18 years, and his 22-year-old daughter has inherited it. "Ive gone from reading standard print to seeing only a few letters at a time," he explained.

His experience mirrors findings in the Health and Social Care Committees report on ophthalmology services. The committee warned that without urgent investment and systemic reform, more patients risk losing vision unnecessarily.

The Welsh government published an ophthalmology strategy last year aimed at reducing waiting times and addressing staff shortages, but the committee noted slow progress, especially in creating regional services.

Shearan used to participate in a running club but had to stop in 2017 as his vision declined. Consultant ophthalmologist Rhianon Reynolds, President of the Royal College of Ophthalmologists in Wales, stated, "I dont think theres an eye unit in Wales that is truly fit for purpose." She highlighted that limitations in personnel, facilities, and funding prevent the system from meeting patient demand.

Ophthalmology was once a smaller specialty with limited treatment options. Over the decades, care has expanded dramatically, reducing permanent vision loss, but infrastructure and workforce have not kept up with the growth. The report noted facilities with leaking ceilings and ivy-covered walls, underscoring outdated and inadequate conditions.

Reynolds also mentioned that the 80,000 patients cited may represent only part of the problem, as those already receiving care require ongoing follow-up that is not captured in official statistics.

For Shearan, delays were worsened when his consultant retired and was not replaced for over a year, and securing funding for treatment in England took additional time. "I had to file complaints before things started to move," he said, describing the anxiety of waiting for treatment that could prevent further vision loss.

Once active in football, judo, and completing the London Marathon three times, Shearans vision started to deteriorate noticeably in 2018. "Its like watching an old TV with channels going off, with black and white spots and pixelation," he explained. His daughter, while currently managing, also faces challenges with bright lights and small print.

Waiting Times and Staffing Challenges

Ophthalmology has the longest patient pathways in Wales and the second-highest number of cases exceeding 53-week waits. Patients are assigned target treatment dates, with health boards expected to see 95% of high-risk patients on time. In January 2025, over 80,000 high-risk patients were waiting beyond their target dates.

Wales has 1.97 ophthalmology consultants per 100,000 population, below the Royal Colleges recommendation of at least three per 100,000. Demand is projected to increase by 40% over the next two decades.

While primary care investment allows optometrists to handle more cases outside hospitals, incompatible IT systems between primary and secondary care cause delays and duplication of effort.

Peter Fox MS, chair of the Senedd Health and Social Care Committee, stated: "Half of all sight loss is avoidable with early detection and timely treatment. Thousands are living with the fear of losing their sight due to delays. We have the blueprint now it must be implemented with accountability, investment, and focus on patient safety." He emphasized that immediate action is necessary to safeguard vision and quality of life in Wales.

Analysis: The Crisis in Ophthalmology Care in Wales

The recent report highlighting the state of ophthalmology services in Wales underscores a critical issue: the gap between growing demand for eye care and the inadequate resources available to meet this demand. Over 80,000 patients at high risk of permanent vision loss are currently facing excessive waiting times for treatment, which is both alarming and unacceptable. This situation reflects broader challenges in the Welsh healthcare system, where delays in treatment are not just a matter of inconvenience but could result in irreversible consequences for patients’ vision.

Experts in the field, including Consultant Ophthalmologist Rhianon Reynolds, have pointed to chronic staffing shortages and outdated infrastructure as the key contributors to these delays. The Royal College of Ophthalmologists in Wales has warned that without urgent intervention and substantial investment, the situation will only worsen, putting more patients at risk of unnecessary vision loss. The need for systemic reform is clear, and it is vital that the Welsh government acts swiftly to address these issues.

While the Welsh government has acknowledged the report and is reviewing the recommendations, the slow pace of change is concerning. Despite the publication of an ophthalmology strategy aimed at reducing waiting times, progress has been insufficient. As demand for eye care continues to rise, it is crucial that both short-term fixes and long-term strategies are put in place to ensure that the health system can provide timely and effective care to all patients.

Kristian Shearan’s personal experience exemplifies the impact of these delays. His struggle to secure timely treatment, along with the emotional and physical toll of worsening vision, highlights the real human cost of an overstretched system. This is not just a matter of inefficiency but of the quality of life for thousands of individuals who face the prospect of living with impaired vision due to bureaucratic inefficiencies.

In conclusion, the situation in Wales calls for a stronger commitment to ophthalmology services. Immediate investment in staff, resources, and infrastructure is essential to prevent further delays and ensure that those at risk of losing their sight receive the care they urgently need. The Welsh government must act with urgency and accountability to deliver on the promise of timely and effective eye care for all its citizens.

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• Am I going to have sight this time next year?