Mr. David Keegan:

I thank the joint committee for this opportunity and thank Deputy Mitchell O'Connor for organising this meeting. I wish to talk about the cost and burden of blindness in Ireland. What is blindness? What does it mean to be blind in Ireland? Members should think about that for a minute. It is frightening, emotional, disconcerting and anger-inducing. Why should it make one angry? Because 75% of blindness is preventable and avoidable. Blindness is defined as best vision of less than 10% of normal vision. That means struggling with all visual tasks up to total loss of sight, not even being able to see lights. Moderate vision impairment is defined as best vision of just 10% to 30% of normal vision, which means not being able to drive, difficulty with reading and that performing many tasks becomes tough and problematic. There is less immediacy in one's life. Mild vision impairment is defined as best vision of just 30% to 50% vision in one's better-seeing eye. This means one cannot drive and one touches loss of independence.

One in 20 people in Ireland is affected by one of the four main eye diseases, namely, cataract, age-related macular degeneration, glaucoma and diabetic retinopathy. This rises to more than one in two people over the age of 80. Each individual eye disease leads to a significant reduction in well-being, which is equivalent to more than 700,000 work days or 2.1 million healthy days lost per annum in Ireland. The financial cost to the State also is considerable. Based on our report, the financial cost to the State in 2010 was €386 million and on current trends, that will rise to more than €449 million by 2020. These costs are manifest in the Department of Social Protection through increased welfare payments and fewer people in the workforce, in the Department of Finance through a reduced tax take and the deadweight loss incurred by transferring moneys from the tax take to the welfare side and of course are felt in the Department of Health through supports and interventions for patients affected by blindness and vision impairment. However, if we introduce interventions such as screening for cataracts and diabetic retinopathy and provide for other early interventions, we can ensure that for hundreds of people, their sight will be retained and will be saving the State hundreds of millions of euro over the coming years. Rather than incurring higher costs, up to €76 million per annum potentially could be saved, were cost-effective measures identified in the strategy concerning the four main eye diseases in Ireland to be implemented. This does not require a significant budget increase but rather, services must be improved through efficient use of existing resources and a redeployment in current resources and expenditure.

People with vision loss and blindness are eight times more likely to fracture a hip, three times more likely to suffer from depression and admission to nursing homes on average takes place up to three years earlier than in the case of those without vision impairment. Moreover,the costs to the State rise significantly from €1,700 per annum up to €21,000 per annum if a person slips from visually impairment to blindness. Preventable blindness is an Irish, European and global issue and not just a Third World issue. The National Vision Coalition outlined earlier by Dr. Meehan is committed to tackling the issue in Ireland. Many of the structures to tackle this already are in place but more help is needed from policy-makers in order that we may co-ordinate a comprehensive and cohesive approach. This can be achieved through a national vision strategy.