Eyecare at work: eyes are the windows to employee health

eyecare at work

Many medical conditions can be detected through routine eye examinations, which are obligatory for the vast majority of employees under health and safety regulations. Jim Lythgow explains how investing in corporate eyecare plans provides benefits beyond health and safety.

The latest figures from Public Health England (PHE) show that diseases caused by high blood pressure are estimated to cost the NHS more than £2 billion a year (Optimity Matrix report, 2014). This is a considerable burden on public spending. What is harder to establish, however, is the cost to business.

What is particularly significant from an employer’s point of view is that more than five million people have high blood pressure, without being aware that they suffer from the condition (PHE, 2014).

Eye checks

An eye examination does a great deal more than simply check that vision is adequate. It can also detect signs of a great number of ocular conditions, including:

  • cataracts
  • conjunctivitis
  • glaucoma
  • keratitis
  • age-related macular degeneration (dry and wet)
  • corneal thinning, eg keratoconus
  • retinal detachment
  • optic neuritis
  • uveitis
  • eyelid skin cancers
  • strabismus
  • ocular tumours
  • amblyopia (lazy eye)
  • dry eye
  • macular hole

What is perhaps less well known is that the process also enables the optometrist to monitor the whole body, and includes the possibility of detecting systemic abnormalities such as raised blood pressure and other conditions including:

  • diabetes
  • brain aneurysms
  • raised cholesterol
  • temporal arteritis
  • cardiovascular disease
  • arthritis
  • cerebrovascular accidents
  • brain tumours
  • thyroid problems
  • pituitary tumour
  • migraine
  • cranial nerve palsies
  • multiple sclerosis

During an eye examination the optometrist will use an ophthalmoscope to examine the retina at the back of the eye. Using this simple torch-like device, the optometrist can view the small blood vessels (capillaries) in the back of the eye, to see if they have thickened, narrowed or burst. This may indicate changes in blood pressure. The eyes are the only place in the body where these capillaries can be viewed and any problems here are often repeated in the small blood vessels in other parts of the body, such as the kidneys, which cannot be viewed without more invasive action.

Statutory eyecare requirements

There are many health and safety regulations covering eyecare at work. The Health and Safety (Display Screen Equipment (DSE)) Regulations 1992 as amended by the Health and Safety (Miscellaneous Amendments) Regulations 2002 cover screen users. Full details of this legislation are available online but the basic rule is that all screen users should be provided with company-funded eye examinations, and glasses if required. Factor in the number of employees requiring prescription safety eye wear, and those who receive eyecare because they drive for work, and we find that the vast majority of employees will be entitled to company-funded eyecare.

If the company or organisation is funding eyecare for the majority of staff, helping to detect issues such as high blood pressure may simply be a matter of choosing the right provider and/or product. While vision screening will assess the ability to see clearly, a full eye examination will assess much wider factors, including eye health and systemic conditions such as high blood pressure, heart disease and diabetes. In this way, an obligatory provision may bring much wider benefits to all.

The optometrist will assess the appropriate intervals for subsequent eye examinations, based on individual requirements. However, it is generally advised for eye examinations to take place every two years.

Procurement of eye care at work

There are various ways of providing eyecare. Many employers still allow their employees to visit an optician of their own choosing and submit an expenses form for reimbursement. The risk with this method is that rates for the examination and the prices of glasses can vary hugely. An employer taking this route may leave themselves open to surprisingly high expense claims.

Research by Specsavers Corporate Eyecare undertaken in September 2014 revealed that more than half (53%) of employers would expect to pay more than £50 for an eye examination and glasses for DSE use. In fact, a full eye examination and glasses for DSE use can cost from as little as £17 per employee.

There is also the possibility of employees receiving differing levels of service and care if they are left to choose their own eyecare provider. Using one provider, at set costs and with set standards of care, allows the employer to remain in control. This could be viewed in the same way as other healthcare plans, where it would be most unusual for an employer not to provide one specific scheme.

Policy and communication

Putting a clear policy in place, stating the chosen provider, the level of care and the accepted process, is likely to result in a fair outcome for both the employer and employee. With the wide range of serious health conditions that can be detected and monitored by a full eye examination, a policy of inclusion for all employees (whether or not they use DSE or have safety eyewear or driving needs) will surely be the most cost-effective approach.

It is important that staff are fully aware of their entitlement so that they are able to claim it, and benefit from the possible health monitoring that is available through eyecare. Under many of the health and safety regulations, communication is a key requirement to ensure compliance.

Indeed, the CIPD “Absence management report”, published in October 2014, makes the correlation between organisations evaluating the impact of their wellbeing spend and the likelihood of them increasing their wellbeing spend the following year. Put simply, this suggests that investing in wellbeing is worthwhile and, if that is true, then ensuring the communication of wellbeing initiatives must also be worthwhile. It is equally important that the provision of eyecare does not become a burden for the HR professional.

Case study

Michelle Seddon, a 28-year-old nursery nurse and mother of two, had noticed a slight deterioration in her eyesight and was suffering from headaches.

Having delayed her routine appointment, Michelle decided to pop into her local Specsavers store while on a shopping trip. Following a full eye examination, Rizwan Iqbal, optometrist and store director at Spescavers in Chorley, suspected Michelle was suffering from intracranial hypertension. This is a severe brain condition, which involves raised pressure in the skull. He immediately referred Michelle as an emergency case to the Royal Preston Hospital.

At the hospital, it was revealed that vessels in Michelle’s skull had narrowed, preventing blood from circulating properly, a potentially life-threatening condition that can cause blindness and strokes.

Michelle spent five nights in hospital undergoing scans and tests. She is now fit and healthy, with the help of medication to control her condition.

Conclusion

Many serious medical conditions can go undetected and the symptoms and delay in action can have severe consequences. These affect not only the employee but have implications for the employer too. An eye examination can help to detect and monitor a large range of medical conditions affecting the eyes and the whole body. The vast majority of employees are automatically entitled to company-funded eyecare, and it can be low cost, low admin and high reward. It can also save time, money and lives.

References

Optimity Matrix report. “Cost-effectiveness review of blood pressure interventions”, carried out for Public Health England, published 18 November 2014.

Public Health England press release. “New figures show high blood pressure costs NHS billions each year”, published 18 November 2014.

CIPD. “Absence management annual survey report”. October 2014.

Legal disclaimer: please note that this is a mere guide only and nothing contained herein shall constitute or be deemed to constitute legal advice and therefore should not be relied upon. Specsavers shall bear no responsibility or liability for the contents, their accuracy or any errors and/or omissions accordingly. It remains the readers’ responsibility to seek their own independent legal advice.

About Jim Lythgow

Jim Lythgow is director of strategic alliances at Specsavers.
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