Technologies to support self-monitoring of vision change for people with macular disease (provisional title)

This topic area has been identified by NICE as a clinical area of importance due to the potential for technologies to help address the high demand on hospital eye services. Waiting lists and waiting times have increased over the past 10 years due to a backlog from the COVID-19 pandemic and a workforce capacity that is under resourced to meet the demand. Prevalence of eye conditions is expected to increase due to population ageing, which would place further demand on hospital eye services. Macular disease includes age-related macular degeneration (AMD) and diabetic macular oedema (DMO). AMD is a common condition that affects people over 50 but can develop earlier. The risk of developing age-related macular degeneration increases with age. AMD is the leading cause of vision loss in people over 50 years old in the UK, with 650,000 people affected. The macula is the central part of the retina, the light sensing tissue that lines the back of the eye. In AMD, the macula becomes damaged in one or both eyes. This causes central vision to become blurred and distorted. If AMD worsens, this can lead to loss of central vision. Peripheral vision is unaffected by AMD. Around 75% of people who have AMD have early, also known as dry, AMD. Early AMD is caused by a gradual deterioration of the macula as the retinal cells die off and are not renewed. Vision loss is usually gradual with early AMD. There is no treatment for early AMD, but support is available to help people live with it. Around 1 in 10 people with early AMD develop wet AMD. Wet AMD develops when abnormal blood vessels grow into the macula. These blood vessels leak blood or fluid which leads to scarring of the macula and rapid loss of central vision. Treatments for wet AMD include anti-vascular endothelial growth factor (VEGF) injections and light treatment to destroy the abnormal blood vessels. Diabetic macular oedema (DMO) is a complication of type 1 and 2 diabetes. It occurs when blood vessels in the eye leak fluid, leading to a build-up of fluid and swelling in the macula. DMO can lead to distortion and loss of central vision. It is a common cause of sight loss in people with diabetes affecting approximately 7% of people with diabetes. Treatment for DMO includes anti-VEGF injections, steroid injections and laser treatment. Some people with macular disease are suitable for self-monitoring of their eye condition at home. Several technologies are available for self-monitoring of macular disease at home. Improved monitoring of macular disease may improve patient outcomes and reduce the burden associated with hospital visits. The technologies may also help hospital eye services to identify people at the highest risk of disease progression and use this information to prioritise appointments. NICE’s HealthTech programme will assess the clinical and cost effectiveness of technologies to support home monitoring of macular disease in order to make recommendations on their use in the NHS.

Status:

In progress

Technology type:

Device

Decision:

Selected

Reason for decision:

Anticipate the topic will be of importance to patients, carers, professionals, commissioners and the health of the public to ensure clinical benefit is realised, inequalities in use addressed, and help them make the best use of NHS resources

ID number:

10073

Provisional Schedule

Scoping workshop:

10 December 2025

Scope published:

08 January 2026

Project Team

Project lead

Bruce Smith

Email enquiries

If you have any queries please email MedTech@nice.org.uk

Stakeholders

External assessment group

CEDAR (Centre for Healthcare Evaluation, Device Assessment and Research), Cardiff and Vale University Health Board

Timeline

Key events during the development of the guidance: