Study highlights impact of language barriers in ophthalmology care

Irish College of Ophthalmologists, Annual Conference, Kilkenny Convention Centre, 21-23 May 2025

There is a growing need for improved access to professional translation services in clinical settings in Ireland, the Irish College of Ophthalmologists Annual Conference 2025 heard.

Dr Emily Greenan, University Hospital Limerick (UHL), presented the findings of a cross-sectional study which found that language barriers significantly affect patient understanding and communication in ophthalmology care.

The study showed that professional interpreters delivered the most effective results.

The study, ‘Lost in translation: Evaluating the impact of language barriers on ophthalmology care’, assessed translation services for patients with limited English proficiency (LEP) attending UHL’s ophthalmology department between September 2024 and March 2025.

Three translation methods were evaluated: Professional interpreters, ad hoc interpreters (such as family members), and translation apps. A total of 49 patients participated (mean age 54.9 years), with Ukrainian being the most common nationality and language (49 per cent). Professional interpreters were used in 44.9 per cent of interactions, followed by translation apps (36.7 per cent), and ad hoc interpreters (18.4 per cent).

In emergency settings, translation apps were relied on most frequently (87.5 per cent), while professional interpreters were most frequently used in outpatient departments (OPDs) (39.3 per cent).

Significant differences were found in patient understanding of their condition (p=0.0045) and in communication accuracy (p<0.0001), with professional interpreters rated highest. Clinicians expressed dissatisfaction with relying on apps or informal interpreters, underscoring the critical role of trained professionals.

Dr Greenan told the Medical Independent that 13 per cent of new referrals to the Limerick ophthalmic OPD, and 13.5 per cent of ophthalmic emergency attendances, involve LEP patients.

“So there is definitely a need there, a growing need, for accessible communication.”

While medical translation apps are helpful in emergencies, “they are just so hard for complex medical situations,” she stated.

She added that family members or friends are not always suitable as interpreters due to privacy concerns or inappropriate role reversal – such as placing this burden on a child.

“Agency interpreters were clearly the preferred option in our study,” she said. “But they are not always available, particularly out-of-hours and at short notice.”

Dr Greenan suggested that the HSE consider launching a centralised call/video interpretation service, operated to national standards and regulations. “I think given the current [geopolitical] context and growing population that the need for translation services is going to continue to grow.”

She also proposed the development of specific-language outpatient clinics where appropriate – for example, Ukrainian – and noted that the current OPD online referral form lacks a specific box to flag translation needs. “That needs to be looked at and tightened up.”

“The HSE is obligated to ensure that healthcare is accessible. As clinicians we want to ensure equitable and safe care for our patients,” she concluded.