Ophthalmology is a high demand specialty, typically accounting for approximately 10 % of all outpatient appointments, regionally and nationally, each year and accounts for 7.1% of all consultant led appointments. In the Northern Ireland context, this demand is in excess of 100,000 acute care appointments annually.

Many ophthalmic conditions are age-related, and many are long-term conditions (LTC’s) where ‘cure’ may not be possible, and management to maintain useful vision the goal. Glaucoma and macular degeneration are such conditions. In addition to the long term or ‘chronic’ ophthalmic conditions, patients who have a sudden onset or ‘acute’ eye condition contribute to the demand for unscheduled or emergency eyecare. Audit and pilot service evaluation has demonstrated that many of these patients could be safely and effectively managed by primary care optometrists. Optometrists working in the community have the knowledge, skills and equipment to assess, triage, manage and treat many of these patients.

Developing Eyecare Partnerships: Improving the Commissioning and Provision of Eyecare Services in Northern Ireland (DEP) is a five year plan to reform and integrate eyecare services with twelve identified objectives. Ophthalmic Services in the Health and Social Care Board have worked collaboratively and in partnership with key stakeholders and service users to plan and implement changes in the eyecare pathways for patients with both ‘long term’ and ‘acute’ eye conditions.

The Optometry / Ophthalmology ECHO Knowledge Networks aim to democratise and de-monopolise medical knowledge, allowing primary care optometrists a safe space to improve their knowledge base, and in turn helping them to better manage patients who

  • Present with suspect glaucoma or macular eye disease
  • Present with an acute eye condition

By tele-mentoring and case-sharing, ECHO will enhance the knowledge and skill in primary care, helping to improve case-handling and referrals patterns. As the Optometry / Ophthalmology Knowledge Networks embed into the clinical practice of both Optometry and Ophthalmology the ECHO community of practice will be developed and strengthened. This will provide the foundations on which DEP can progress further service developments in the eyecare pathways. Supported by the educational governance and communications portals which ECHO affords, the vision of ‘shared’ care for patients with stable long term eye conditions in the primary care setting can be realised which will help to manage demand and facilitate the treatment of patients closer to home. In this way, optometry primary care can be fully utilised, ensuring that each element of the ophthalmic workforce works to the top of their licence, helping to manage demand and delivering patient-centred, local and accessible care.

Hub Facilitators

Raymond Curran image

Raymond Curran

Head of Optometry,

Health & Social Care Board


Margaret McMullan image

Margaret McMullan

Optometric Advisor

Health & Social Care Board


Prof Augusto Azuara-Blanco image

Prof. Augusto Azuara-Blanco

Clinical Professor

Queen’s University


Michael Williams image

Michael Williams

Consultant Ophthalmologist

Belfast Health & Social Care Trust

Usha Chakravarthy

Professor Usha Chakravarthy

Clinical Professor

Queen’s University, Belfast

Consultant Ophthalmologist

Belfast Health and Social Care Trust

Fiona North image

Fiona North

Optometric Advisor

Health & Social Care Board

Dates and Times

There are 2 Ophalmology ECHO networks – Acute Eye (Optom 1) and Macular and Glaucoma (Optom 2)

Acute Eye Programme

Friday 2 Sep 16


Flashers & Floaters

Friday 30 Sep 16


Red Eye

Friday 28 Oct 16


Disc Disease

Friday 25 Nov 16


Sudden Sight Loss

Friday 16 Dec 16


Cornea/Contact Lens

Friday 27 Jan 17


Dry Eye

Friday 24 Feb 17



Friday 31 Mar 17



Friday 28 Apr 17



Macular and Glaucoma

9th September (Macular)

Retinal Vein Occlusion


7th October (Macular)

Multimodal Imaging / Differential Diagnosis

28th October (Macular)

Diabetic Macular Oedema


25th November (Glaucoma)

New and emerging treatments/surgery


16th December (Macular)

Vitreo-retinal interface

20th January (Macular)

Investigations and Interpretation


17th February (Glaucoma)

Enhanced case finding in primary care & fields progression in monitoring


24th March (Glaucoma)

Current treatment options & systemic medications