In recent months, concerns have been expressed by some members of the public about access to eye surgery, particularly for cataracts.
Increased demand for cataract surgery and a lack of capacity for extra work prompted Dunedin Hospital to raise the threshold for such operations last year. For some years, people with eye conditions classed as routine have been returned to the care of their family doctor.
Board chief funding and financing general manager Robert Mackway-Jones said information about the amount of cataract surgery done by other boards indicated Southern had a lower rate compared with the rest of the country, on average, so ongoing increases were desirable.
The national target for cataracts was 27 operations for every 10,000 people and Southern's rate in 2009-10 was 26.75.
However, the national average was almost 31.
For eye surgery generally, the board rate was 44 for 10,000 people, five lower than the national target and about middle of the field when compared with other boards.
Mr Mackway-Jones said funding for the coming year had allowed a small percentage for dealing with expenses related to population growth and ageing.
This meant there was a limited ability to fund growth in services, "recognising we are still running deficits".
Dunedin Hospital emergency medicine and surgery group manager Dr Colleen Coop said the hospital expected to meet , "or be close" to its target 500 cataract procedures at the end of the financial year in June.
At the moment, 24 people had waited longer than six months for surgery, she said.
Concern about access to eye surgery at the hospital has been expressed to the Otago Daily Times recently by two prospective patients.
One, kept waiting longer than six months before being given a date for her cataract surgery, said she had had two falls during her wait for surgery, something which had undermined her confidence.
In her 50s, she said her lack of sight had a huge impact on her life and those around her, but she imagined it would be more frightening for an older, more frail person.
She was also annoyed that it appeared only one of her eyes would be operated on because the return of some vision would mean she did not have enough points to qualify for the second surgery.
"They don't do that with hips."
Dr Coop said when an individual had two dense cataracts, surgery was provided for one first.
Very few people had both done at the same time, as it would leave them fully blind for at least 24 hours.
After the first operation they would then come to a clinic and be re-scored with their new sight on the clinical priority assessment criteria (CPAC) scoring system.
This was to ensure everyone was dealt with equitably.
If their vision had improved past the point where "we would normally provide surgery for cataract patients" then they would not be approved for the second operation at that time.
However, if the individual needed the second cataract operation for other purposes - such as personal safety - and the case was considered suitable for "clinical override" when reviewed, then the person would receive the second operation.
The other woman, who is in her 20s, has not been seen by a specialist because her squint condition is classed as routine.
She has been referred back to the care of her doctor, who cannot do anything to improve her condition, and private surgery was not an option she could afford.
She cannot drive and she believes the condition lowers her chances of being able to get a job because it affects her appearance.
When patients like her were not able to get in to see specialists, it was hard to know how their situation stood up against other people's and what account was made of the impact on the patient, she said.
Dr Coop said as the hospital did not have the appointment space to see all referrals which came in, it asked for as much information as possible to be in the referral so the consultant could make an assessment based on all the relevant facts.
In the last six months, about 54 people a month referred for cataract surgery or other procedures did not receive an appointment with a specialist.
Patients with routine conditions who were referred back to their GP could request a re-referral if their vision had altered.
If there was an acute change, they could ask to be referred to the acute eye service.
Among the conditions listed as routine are myopia, blocked tear ducts, itchy eyes, watery eyes, squints, conjunctivitis, and inflammation of the eyelash follicles (blepharitis).
Asked about the impact of the appointment of a 0.4 full time equivalent specialist beginning this month, Dr Coop said this would help with following up patients who had been waiting for a lengthy period with chronic conditions.
The new specialist would undertake two clinic sessions and one theatre session per week at Dunedin.
