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With the right training, support and commissioning, independent pharmacies can manage minor eye conditions as part of more coordinated care with optometrists. Victoria Goldman explains…

According to Dr Gillian Ruddock, president of the College of Optometrists, in March 2026, the government’s Neighbourhood Health Framework failed to highlight the important role of primary eye care professionals such as optometrists.

Like community pharmacists, optometrists are located within the heart of local communities and are accessible, well-equipped and staffed by skilled healthcare professionals.

Community pharmacists and optometrists both play an essential role in helping to manage acute and chronic eye conditions outside the hospital setting and are often the first ports of call for eye health concerns, rather than the GP surgery.

Strengthening the pharmacist-optometrist working relationship should therefore benefit patients’ overall eye health within primary care.

“Community pharmacists and optometrists already work together in some areas of patient care, including referral and signposting pathways for common eye conditions,” says Amandeep Doll, Royal College of Pharmacy (RCPharm) Director for England.

“For example, pharmacists may refer patients for further assessment where symptoms require specialist input, while optometrists may direct patients to community pharmacy for advice and treatment for self-limiting conditions. With the right training, support and commissioning, community pharmacies could build on their existing role in supporting self-care and managing minor conditions as part of more coordinated care with optometrists.

“Strengthening these relationships through clear referral routes, shared care approaches and local commissioning could help deliver more joined-up care for patients.”

Encouraging collaboration

There are many ways in which community pharmacists and local optometrists could work together directly to improve patients’ eye health, especially in the management of common or acute eye conditions such as dry eye, blepharitis, allergic eye disease and minor infections. This could be informally or as part of a formal commissioned NHS service.

According to Dr Paramdeep Bilkhu, clinical advisor at The College of Optometrists, eye care is a specialised area and should be delivered by eye care professionals.

“However,” he says, “where possible, commissioned services should include support for patients to access medicines/treatments from pharmacies.

“Supporting cross-referral, particularly for urgent or emergency presentations, will help patients get the care/treatment they need, with appropriate urgency to help prevent avoidable sight loss.”

Lindsey Fairbrother, a freelance pharmacist and chief officer for Shropshire LPC, says that joint educational sessions between community pharmacists and optometrists would help to encourage a two-way referral system.

“Optometrists may need to better understand the role and expertise of their local community pharmacist, and vice versa,” she says. “Pharmacists often see patients with dry eyes or red eyes or buying stronger ‘ready reader’ glasses regularly.

“If they are concerned about a patient’s eye health or vision, they should be referring them to an optometrist. In turn, optometrists should be referring patients to a pharmacist for medicines advice, to improve compliance. Pharmacists can discuss which medicines the local optometrists are prescribing or recommending and make sure they have these in stock.”

Day-to-day support

Community pharmacists and optometrists often see patients with chronic eye conditions more regularly than a hospital ophthalmologist.

Glaucoma affects around two per cent of adults over 40, rising to around 10 per cent of those over 75, and currently accounts for 20 to 25 per cent of all hospital eye services outpatient activity. However, delays in hospital diagnosis and treatment are increasing the risk of avoidable and irreversible sight loss from the condition.

In April 2026, the College of Optometrists called for an increase in community care delivered by optometrists for patients with low-risk and stable glaucoma, to reduce pressure on hospital services across England and Northern Ireland. Bringing routine glaucoma care closer to home through local optometrists could also bring more glaucoma patients into community pharmacies for medicines advice.

“Patients with ongoing eye conditions may seek support from their local pharmacy, particularly around medicines use, adherence and managing side effects,” says Amandeep Doll.

“While the diagnosis and clinical management of chronic conditions such as glaucoma sits with specialist services, pharmacists can play a valuable role in supporting safe and effective use of treatments and improving patient understanding of their condition.”

Dr Louise Gow, RNIB’s head of optometry, low vision and eye health, says that pharmacists should check whether glaucoma patients are able to put their eye drops in.

“If someone is struggling with their glaucoma drops, they may lose vision as a result,” she says. “Discussing the barriers, encouraging them to seek advice from the hospital or showing them how drop dispensers might help, could make all the difference.”

Understanding red flag symptoms for serious or long-term eye conditions is essential for community pharmacists, so that opportunities to prevent sight loss aren’t missed.

“The wrong advice at the early stage of an eye problem can mean that help is sought too late,” says Dr Gow. “If community pharmacists get to know which services the local optometrists offer, such as CUES (Community Urgent Eyecare Service) or MECS (Minor Eye Conditions Services) to avoid unnecessary A&E visits, this can result in better outcomes for everyone.”

Collaboration in Wales

The Common Ailments Service in Wales covers conjunctivitis and dry eyes and includes referral guidelines for pharmacies, although patients are encouraged to visit an optometrist first for eye conditions.

“We have been fortunate in Wales with the Common Ailments Scheme, where pharmacists can refer to the optometrist, and optometrists can refer back to the pharmacist if needed,” says Gareth Hughes, pharmacist independent prescriber and RPS Welsh Pharmacy Board member.

“The new optometrist NHS Signed Orders scheme is now making the referral process even smoother for patients.”

Since the beginning of April 2026, community pharmacies in Wales have been able to supply patients with a limited list of optometrist-ordered medicines and appliances. This new NHS Signed Orders scheme enables patients with acute eye conditions to bypass GPs, moving straight from an optometry diagnosis to pharmacy supply.

Patients receive the eye treatments free of charge, while pharmacies are reimbursed for medicine costs and receive a professional supply fee.

“The new NHS service in Wales is a positive step towards more structured collaboration between optometrists and community pharmacists as it creates a more direct and efficient pathway for managing common eye conditions,” says Geraldine Mccaffrey, RCPharm director for Wales.

“This builds on existing working relationships by formalising them, helping patients access treatment more quickly while making better use of clinical skills across primary care. If implemented well, it could provide a useful example to inform similar approaches in other parts of the UK, with the right commissioning, training and system support in place.”