Senedd warning over long waits for eye care in Wales
A Senedd committee has warned that urgent action is needed to address long waits in eye care services across Wales, with more than 80,000 high risk patients waiting beyond clinically safe timeframes for treatment.
The Health and Social Care Committee said immediate steps are required to prevent avoidable sight loss, describing the National Clinical Strategy for eye care as a clear blueprint that should be accelerated.
The report, published this month, notes that while recent reforms in primary care have delivered benefits, they cannot compensate for longstanding weaknesses in hospital based services.
At the end of March 2025 around 80,700 patients assessed as Health Risk Factor R1, the highest category for risk of irreversible harm, were waiting too long for treatment. This represents 50.1 per cent of all R1 pathways.
No health board currently meets the national standard requiring 95 per cent of patients to be seen within target times.
Ophthalmology remains the busiest outpatient specialty in Wales.
One in every eight patients on the NHS Wales waiting list is waiting for an ophthalmology appointment and one in 20 people in Wales is currently waiting for eye care.
Demand is projected to rise by 40 per cent over the next two decades due to an ageing population and conditions such as diabetes and glaucoma.
Reforms to the Wales General Ophthalmic Services contract have allowed optometrists to manage more low risk and urgent cases in the community.
In October the Welsh Government announced an additional £3 million funding for optometry as part of the 2025 to 26 contract, following a £3.9 million uplift earlier in the year.
About 3,000 hospital appointments per month have already moved into community optometry with a target of 30,000.
A separate funding package announced in June aims to deliver 20,000 additional cataract surgeries.
The Committee said these improvements are outweighed by delays in secondary care.
Patients have described the emotional and practical impact of waiting. Sara Crowley said delayed treatment cost her independence and employment.
RNIB Cymru said some grandparents had lost sight before meeting newborn grandchildren.
Edward Kenna, who has macular degeneration, said he felt “condemned” to lose his sight.
RNIB Cymru said there is “almost certainly a significant underreporting of the scale of harm befalling patients”, noting that between June 2021 and September 2023 only 45 harm incidents were recorded despite tens of thousands of people waiting beyond safe timeframes. The Committee also heard about communication difficulties and the absence of emotional support roles such as Eye Care Liaison Officers.”
Systemic challenges highlighted by the inquiry include workforce shortages, limited theatre and clinic space, outdated equipment and slow progress on digital systems.
Wales has 1.97 consultant ophthalmologists per 100,000 population, below the recommended three.
Consultant Ophthalmologist and national clinical lead for ophthalmology, Rhianon Reynolds, described hospital facilities as cramped, with leaking roofs and broken equipment affecting services.
Nearly five years after launch, most health boards still do not have a fully functioning OpenEyes electronic patient record or electronic referral system.
The Committee makes 16 recommendations. These include establishing a cross sector ophthalmology oversight board before the 2026 Welsh general election, committing to a multi year investment programme for secondary care, accelerating the rollout of OpenEyes by March 2026, developing regional centres of excellence, improving estates and equipment and increasing training places.
The Welsh Government has six weeks to respond to the recommendations before the report is debated in the Senedd.
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