New report from Scottish Parliamentary roundtable reveals the urgent need for enhanced diagnosis and treatment to address Scotland's national health crisis and prevent widespread vision loss

EDINBURGH – Today marks the release of a new report of a Scottish Parliamentary roundtable (arranged by ophthalmologic medical technology company Glaukos UK), highlighting the severe glaucoma crisis in Scotland. With up to 50% of glaucoma patients non-compliant with their current treatment of eye drops, significantly increasing the risk of disease progression and eventual blindness, the report calls on key stakeholders across the ophthalmology ecosystem in Scotland to tackle critical concerns around patient care and to outline a vision for transforming glaucoma treatment across the nation by making stent-based trabecular micro bypass at the time of cataract surgery the standard care option for patients with glaucoma.

At present, Scotland is facing an urgent health crisis as glaucoma, the second leading cause of blindness worldwide, continues to have a devastating impact. An estimated 150,000 Scots are living with this debilitating condition, yet Scotland is plagued by a dire shortage of ophthalmologists, ballooning waiting lists that have surpassed 250,000, and a concerning underutilisation of new and effective surgical technologies. This crisis not only imposes a significant financial burden, with costs expected to soar to £33.5 billion by 2050, but also contributes to increased economic inactivity among both affected individuals and their caregivers. The severity of Scotland’s glaucoma crisis is underscored by the startling reality that many individuals are suffering preventable vision loss. Often referred to as the ‘silent thief of sight’, glaucoma progresses unnoticed until substantial and irreversible damage has already occurred. 

The key findings of this report call for a comprehensive overhaul in Scotland's  approach to glaucoma treatment, a shift that has become increasingly urgent as the healthcare system struggles to keep pace with growing demand. With diagnostic rates alarmingly low and potentially as many undiagnosed cases as those already identified, roundtable participants unanimously agreed that prioritising early intervention, embracing cutting-edge technologies, and streamlining patient pathways are crucial. Additionally, the report also calls for greater collaboration between the sector and the Scottish Government to develop a more accurate model that fully captures the benefits of early and effective glaucoma intervention. These steps are essential not only to significantly improve patient outcomes but also to mitigate the severe economic strain on the healthcare system caused by inadequate eye care.

The current approach often relies on a one-size-fits-all method, with eye drops—despite their limitations—being the default treatment. As Stewart Gillan from Ninewells Hospital & Medical School points out, "For many patients, the drops are the mainstay of treatment. And what we find happening, though, is that if one drop doesn't work terribly well, we'll add in a second drop. And if that doesn't work, we'll add in a third drop. And sometimes patients are putting in four drops to try and control their glaucoma. But what we know is actually going on is that many patients just aren't getting their drops in effectively. Many patients aren't actually taking their drops at all."

That so much reliance is placed on patients to adhere to eye drops underscores the need for integrating innovative medical technologies, such as the iStent inject® W— a device with over a decade of proven success — into standard care protocols to significantly improve patient outcomes. Scotland’s sluggish adoption of new technologies remains a significant hurdle that must be overcome.

The iStent inject® W, developed by Glaukos UK, is a groundbreaking device that improves glaucoma treatment by enhancing the outflow of aqueous humour and lowering eye pressure. As the smallest implantable device in the human body, it has been used in over one million cases worldwide, boasting a decade of proven safety and effectiveness. It offers a reliable alternative to inconsistent eye drops and can be cost-effectively combined with cataract surgery. Despite its benefits, over 4,000 patients annually in Scotland lack access to this treatment. Integrating products like  iStent inject® W into the glaucoma patient pathway in Scotland could enhance early treatment, halt disease progression, and reduce long-term health and social care costs.

The report is an urgent warning for Scotland’s glaucoma care system that is currently facing significant challenges.  Scotland must urgently invest in ophthalmology training and infrastructure, enhance collaboration among all stakeholders, and develop precise financial models that reflect the true costs of glaucoma. By prioritising early intervention and overhauling patient pathways, Scotland has a crucial opportunity to revolutionise its glaucoma care approach and ensure that no patient is left behind.