How can optical benefits help to detect and manage certain health conditions?

More than two-thirds (69%) of employers believe that eyecare is a relevant benefit for employees aged over 40 because it can help to detect and monitor serious conditions, such as high blood pressure and diabetes, according to research by Specsavers Corporate Eyecare, published in April 2017. A further 40%, meanwhile, believe that this is also a relevant benefit for staff aged under 40.

With this in mind, optical benefits can play a role in helping employees to proactively manage new or existing health conditions.

Statutory obligations
The Health and Safety (Display Screen Equipment) Regulations 1992 dictate that employers must fund an eye and eyesight test for all employees who use computer screens, laptops, or similar devices for work. If the test reveals that an employee requires eyewear solely for display screen equipment (DSE) work, then the employer must fund the full cost of the glasses, including the basic frame and lenses.

Employers are only obliged to fund the basic eyewear appliances that are required purely for display screen work, and only if the employee’s own day-to-day glasses are not sufficient for this type of work. Employers must also provide safety eyewear where needed.

Employers also have an element of responsibility for employees who drive for business purposes. Although it is up to the employee to ensure they are fit to drive, a fatal accident caused by an employee’s poor eyesight while driving for work can have legal implications for employers under the Corporate Manslaughter and Corporate Homicide Act 2007.

Optical benefits above minimum

Employers that offer their staff optical benefits that reach beyond the statutory requirements can help employees to adopt a more proactive stance to mitigating and managing potential chronic health risks. This is done by initially flagging symptoms that may fly under the radar at a basic eyesight test.

Jeremy Chadwick, managing director Europe, Middle East and Africa (EMEA) at optical plan provider VSP, says: “A thorough eyesight examination covers a far wider range of eyesight tests which can reveal chronic disease risk. It can pick up chronic disease risks such as diabetes up to seven years before any other check, and [for] risks such as hypertension [and] high cholesterol, the eyesight examination is the first test to pick it up around two-thirds of the time. In terms of serious health risks and unmanaged health risk, from an employer point of view, going above and beyond the legal minimum makes a lot of sense.”

Thorough eyesight examinations can also detect early symptoms of certain forms of cancer, as well as specific vision-related conditions such as glaucoma and early stage cataracts.

Optical benefits can also be used to engage a workforce with their overall health, especially if staff already use the available statutory eyecare benefits, says Christopher Bailey, senior health and benefits consultant at Mercer. “What [eyecare] does do is touch on the whole population, so everyone regardless of age, [regardless] of fitness levels or previous [conditions] needs to have regular eye tests at least every two years,” he says. £The fact that employers are facilitating those tests means that employees are more likely to go.”

The wider wellbeing picture
The role of enhanced optical benefits can be wide-ranging in terms of forging healthcare pathways to help employees manage health conditions and associated risks. “The role of eyecare is that gateway product to then link in to the [NHS] as appropriate, or private medical as appropriate, for some follow up on specific conditions,” explains Chadwick. “The role of the optometrists is to signpost things for other medical professionals, such as the GP.”

Employers can align optical benefits with employee benefits such as an online GP service or GP concierge service, as well as private medical insurance (PMI) and health cash plans. These benefits are particularly pertinent in helping employees manage their health because they can facilitate access to an early diagnosis and a quicker route to any required treatment, following the detection of potential symptoms during eyesight examinations. Bailey says: “Employers can provide benefits that take that next step if there is a diagnosis or condition, or facilitate an arrangement for a self-pay basis.”

For example, a self-pay arrangement could see employers providing access to a private clinic through a healthcare scheme or via a discounted arrangement, such as a zero-interest payment plan for employees requiring surgery.

Thorough eyesight examinations can also impact group risk benefits, such as life insurance, income protection and critical illness, because the early detection of early symptoms of chronic conditions can mitigate the disease risk, which may reduce group risk costs. In addition, the early intervention and rehabilitation services associated with group risk products can help employees manage a potential health condition if early symptoms are spotted during an eyesight exam. “Vision care doesn’t just stand alone,” says Chadwick. “It’s part of those bigger products and has a role in helping the individual and also the employer [to] have better outcomes and, hopefully, better financial outcomes as well as better health outcomes.”

Enhanced optical benefits
So, what can employers do to enhance their optical benefits offering? First, employers should consider providing education around eye health and eyesight examinations, as well as inform staff about the role these exams have in spotting disease risk. This, in turn, can help employees to understand how vision care can support them in safeguarding and managing their overall health more proactively. “Most people have no experience of eyecare or eyesight examinations until potentially they have a problem,” says Chadwick. “We’re not very well educated at an individual level so we don’t understand this role of vision, and that’s both a challenge and an opportunity to get people participating.”

Education can centre around the basics of what happens in an eyesight examination, how optical benefits work and general eye health pointers, however, it can also consider lifestyle factors, such as how much screen work employees undertake, the risks of not taking regular screen breaks and the effects of blue light from devices such as smartphones  and tablets.

Employers should also consider implementing a separate optical plan as part of their benefits provision, rather than just the cover provided by a health cash plan, says Mercer’s Bailey. “Where optical plans can be of real benefit is taking on the benefits that cash plans offer and really enhancing them,” he explains. “Cash plans do a great job, but they do fund quite a range of benefits, and people are equally likely to have dental needs or physiotherapy needs under a cash plan. Therefore, the reimbursement levels that cash plans can provide are reduced, whereas with a dedicated optical plan, [employees] are looking at a good level of eyecare [that] can leave individuals with little or no top up themselves.”

Employers can also review the reimbursement levels across relevant benefits, such as an optical plan or health cash plan, to ensure that employees can access whole eye health tests that use the latest scanning equipment, adds Bailey.

Providing easy access to optical benefits is vital to ensure employees take advantage of the support available. One way of doing this is through on-site optometry and mobile arrangements, however, employers need to have the policies and flexibilities in place to allow employees time out of the working day for their appointments. Abby Pringle, corporate eyecare manager at Specsavers Corporate Eyecare, says: “Being flexible when [employees] can take the test is important.”

Employers also need to be aware of they reasonable adjustments they can implement in the workplace if employees are referred to their GP with symptoms of a sight-related condition, adds Laura Matthews, workplace wellbeing consultant at Barnett Waddingham. This could include support technology, such Dragon Sight, which uses speech recognition software to aid employees who may have vision troubles.

Eyecare innovation
Technology is also impacting the effect eyesight examinations can have on preventative health approaches. For example, methodology is currently being developed to enable Alzheimer’s disease to be diagnosed via an eyesight exam, following research conducted by the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai in Los Angeles that was published in August 2017.

Technology such as optical coherence tomography (OCT) is also becoming more widely available. This is a non-invasive imaging test, similar to a magnetic resonance imaging (MRI) scan, which uses light waves to take cross-section pictures of the retina. “It’s allowing us to take a full scan of the eye, which can monitor very slight changes in the shape of the eye or any structural changes [and] can pinpoint certain conditions such as high blood pressure,” explains Pringle

Also available is digital diabetic retinal photography, which can help spot symptoms of diabetic retinopathy; a condition diabetic individuals can contract that can lead to blindness.

Employer-provided optical benefits can play a vital role as part of an all-encompassing, preventative health and wellbeing strategy. Employers should, therefore, consider the provision of information that educates employees on the importance of healthy eyes in relation to wider health condition, as well as offering access to relevant benefits.