Dr. Jane Barratt
Secretary General, International Federation on Ageing
Vision loss from certain retinal diseases is preventable. But it does require patients to have equitable access to assessment and treatment.
Just over two million Canadians will experience irreversible vision loss from retinal disease. Age-related macular edema, diabetic retinopathy, glaucoma, and cataracts are some of the conditions that increase the risk of sight loss.
One misconception about retinal eye disease is that it’s an inevitable part of aging or diabetes. But with early assessment, treatment, and monitoring, this doesn’t have to be the case. “Many retinal diseases are preventable and treatable. It doesn’t have to take over your life and the earlier you catch it, the greater the chance of good outcomes,” says Dr. Jane Barratt, Secretary General of the International Federation on Ageing (IFA).
To adequately address the multiple ways and barriers to access treatment, we’ve got to expand the vision health options and to do that, we need effective policies that are informed by evidence.
Advances and innovation in treatment lead to better outcomes
Continued innovation and advancements in ophthalmology have resulted in more Canadians with retinal eye diseases living independent and productive lives. One of the most common treatments for people with age-related macular edema or diabetic retinopathy is anti-vascular endothelial growth factor (anti-VEGF) therapy. “This is a state-of-the-art and very important treatment that works to slow down vision loss and support people with retinal eye diseases,” says Dr. Barratt.
As a patient advocacy organization, the IFA believes that people who need biologic anti-VEGF therapy should continue to have access to it. “Biosimilar anti-VEGFs are being introduced on the market, and while there’s nothing currently suggesting that biologic anti-VEGFs won’t be available, we’ve seen non-medical mandatory switching in provinces where biosimilars have been used to treat other conditions,” says Dr. Barratt.
In the field of ophthalmology, data on the implications of switching is currently lacking. “This evidence is critical to inform policy development to ensure patients are receiving safe, appropriate, and effective treatment for their condition,” says Dr. Barratt. “We feel it’s important that physicians are not only up to date with the evidence around biosimilars in ophthalmology, but that there are patient and clinician conversations about the most appropriate treatment for that individual and that the patient has a choice.”
A need to broaden treatment access and options
With the progressive nature of retinal eye diseases, it’s critical to catch them early, and that requires access to assessment and treatment.
That can be challenging in Ontario. In addition to the recent pandemic lockdowns, which prevented many people from receiving timely eye care, leading to devastating vision loss, Ontario has a complex health-care system. For example, a patient with diabetes may be required to start with a diabetologist before being referred to an ophthalmologist, which can take additional weeks or months. In the meantime, there’s potential for further vision deterioration.
Another challenge is cost. Not all eye care is covered under the Ontario Health Insurance Plan (OHIP). “Some treatments for retinal diseases, such as laser, steroids, and anti-VEGF, are covered, but much of it is private,” says Dr. Barratt. “To adequately address the multiple ways and barriers to access treatment, we’ve got to expand the vision health options and to do that, we need effective policies that are informed by evidence,” says Dr. Barratt.
The lack of access has consequences. “It affects the whole social and economic fabric of society. People may lose their jobs, their personal system of care, and their identity, and there’s a marked increase in mental health issues for people with vision loss,” says Dr. Barratt.
This article was made possible with support from a research-based pharmaceutical company.
