Eye Care Meets Blood Pressure: A New Kind of Check-Up

3 March 2025

Early detection of hypertension through routine optometry visits can lead to timely interventions, including lifestyle modifications and medical treatments, ultimately improving patient outcomes.

Recognising this potential, the NHS has recently launched a series of pilots offering free blood pressure checks during routine optometry appointments. Optometry practices are particularly well-placed to contribute to cardiovascular health due to their frequent patient interactions, accessibility, and the trust they have established within communities.  They are also able to pick up patients who may not attend other primary care settings. For example, people may avoid going to a GP but may need to go to their high street optometry practice for glasses.

---

Aims and Objectives

The service aims to identify individuals with raised blood pressure and potential undiagnosed hypertension, thereby reducing their risk of heart attacks and strokes. This is a vital step forward in revealing where medical issues might be present, but undetected, as high blood pressure often presents no symptoms, leading to an estimated 4.2 million people in England being unaware of their condition.

By integrating blood pressure monitoring into optometry practices, the NHS seeks to reach patients who might not regularly engage with other services and who remain unaware of their health risks. The move builds on the success of previous community pharmacy-based blood pressure checks, which have carried out over a million assessments in the past year.

---

Implementation and Reach

The pilot has been introduced across 15 Integrated Care Boards (ICBs) in England Primary Eyecare Services is currently running trials focusing specifically on optometry settings in:

• Greater Manchester
• Lancaster and South Cumbria
• Gloucestershire
• Cheshire and Merseyside

With the current pilot happening in 15 local ICBs, six areas will focus on case-finding at dentists, five in optometry, and four will be offering checks at both dental and optometry sites.

---

Preventing Medical Emergencies

When we introduced routine blood pressure checks in our Greater Manchester optometry practices, we anticipated identifying patients with elevated readings, but the real impact of this initiative became clear sooner than expected.

During the first fortnight of the trial, two individuals were found to have dangerously high blood pressure levels. Notably, the patients had not previously exhibited any obvious symptoms that would have suggested such a severe condition, although one patient did report she felt dizzy while having her fundus photographs taken. The optometrists were well placed to offer a blood pressure reading and, in both cases, the readings were significantly above normal, prompting our optometrists to take immediate action.

Following clinical protocols, in both cases the teams contacted emergency services, and the patients were immediately taken hospital by ambulance. Without this intervention, these individuals were at high risk of experiencing life-threatening events such as heart attacks or strokes.

This experience has underscored the critical role that optometry practices can play in detecting systemic health issues. By incorporating blood pressure checks into our standard practices, we are not only supporting eye health but also contributing to the wider wellbeing of our communities.

In total ~900 patients have had their blood pressure in three months across Greater Manchester to date. Some 23.2% of the patients we have tested have been referred on for further support, with 76.8% discharged from the service with a normal reading.

---

Addressing Hypertension Through Collaborative Care

When a patient attends an optometry practice for their eye examination, the optometrist or a member of the wider team will offer to take a blood pressure reading, if appropriate, and if certain criteria are met. The service is unique in that it does not have to be carried out by a professional clinician. Anyone in the practice can be trained to undertake the process – from receptionists and optical assistants to senior practitioners.

Depending on the outcome of the readings and local protocols, patients will be offered:

• Advice and guidance on health and lifestyle
• Referral to a community pharmacy for follow-up through the Hypertension Case-Finding service
• Referral to GP where appropriate for further investigation, those patients suspected of being in a potential hypertensive crisis situation will be immediately referred to A&E, NHS 111 or 999.

---

Future Directions

The NHS blood pressure monitoring pilot within optometry practices marks a significant advancement in preventive healthcare. Leveraging the accessibility and trust of optometry services could pave the way for broader implementation across the UK, reflecting a shift towards a more holistic, preventive approach of direct benefit wider public health.