DR. DR. SAM, DIRECTOR OF THE DEPARTMENT OF PERSONAL HEALTH CARE ZDISLAV SKVARCIANY: "OPTOMETRISTS WILL HELP SOLVE SOME OF YOUR VISION PROBLEMS..."

Ophthalmologists face many challenges in their work today. Perhaps the most important of these is to provide treatment based on modern technology and science, and to reduce queues at ophthalmology surgeries, reduce waiting times for operations and examinations as patient volumes increase...

We talk to Dr Zdislav Skvarciany, Director of the Department of Personal Health Care at the Ministry of Health, about what life is like for ophthalmologists today.

Ophthalmology in Lithuania - how would you assess the current situation? What are the biggest challenges facing ophthalmologists today, and how are health policy makers helping them to address them?

With an ageing population, an increasing number of environmental risk factors, an increasing pace of life and stress, the number of people suffering from chronic non-infectious eye diseases is also increasing. These trends are observed throughout Europe. Today, ophthalmology is still facing major challenges in terms of how to provide treatment based on modern technology and science, how to reduce queues at ophthalmologists' surgeries, and how to reduce waiting times for operations and examinations in the face of increasing patient flows. As I said, these problems are not only in Lithuania. However, modern treatment will not be achieved by new technologies alone, so we must strive to keep the best specialists in our medical institutions.

How would you assess the accessibility of today's patients to an ophthalmologist - how long do they have to wait for a consultation? Or do queues form only in big cities or for individual specialists, or are there no queues in smaller towns?

Patient funds monitor patients' access to doctors' waiting lists and publish average waiting times online. I believe that the problem in this area is not as significant as is often said. According to the data of the State Patients' Fund (SPC), ophthalmology services, paid for by the budget of the Compulsory Health Insurance Fund (CHIF), are being provided this year in more than 200 medical institutions, with more than half of them having a waiting time of up to 7 days (as of June this year). Longer queues occur when patients choose the specialist they want to see and are willing to wait for that specialist to consult them.

As Lithuanian patients with a referral can choose which specialist to see and in which country's medical institution, if they need a quicker consultation, there is always the option of checking where the queues are shorter and taking advantage of this.

On the other hand, it is important to take advantage of preventive eye examinations, i.e. not to wait until an acute visual impairment occurs. Preventive eye examinations can be scheduled in advance by obtaining a referral from your family doctor, or by making an appointment for an extended consultation. It is particularly important for parents to make sure that their children have an eye examination, as all the conditions are in place for this (for example, when a child's health certificate is required to be presented at the time of the child's enrolment in school or nursery).       

Some time ago, the media was abuzz with reports of misunderstandings about Lithuania's purchase of low-quality lenses for cataract treatment and medical advice to patients to pay more money and buy better, higher quality lenses. What is the situation today - has this problem been solved and long forgotten?

I think this problem has been adequately solved and it is entirely up to the decisions of the medical institutions that carry out the eye lens surgery. In fact, it is now up to the medical institutions themselves to acquire the quality eye lenses that their patients need, which are of a high quality and have different characteristics. This means that every institution carrying out these operations must have and offer the patient a quality eye lens that is suitable for them free of charge, but it is also possible to offer the patient lenses for which they may have to pay extra. It is therefore up to the patient to choose. The average cost of an eye lens used in cataract surgery (€44.02) is included in the cost of the surgery, and the average cost of an average treatment case is €339.48.

So I want to emphasise that the purchase of lenses for cataracts is done by the medical institutions themselves. The free lenses are of high quality and their cost is included in the price of the service. It should be noted that medical institutions have a duty to ensure that patients receive a quality service.

Read more in "Lietuvos optalmologija" 2016 Nr. 2