Some South Auckland people are losing their sight as doctors struggle to treat the soaring number of patients suffering from eye conditions.
Thousands of people across the country are still waiting longer than intended for follow up eye-appointments, with the backlog at Counties Manukau DHB remaining stubbornly high.
The number of patients visiting Counties Manukau's ophthalmology department has skyrocketed in recent years, from 18,000 to 50,000 annually.
Counties Manukau head of ophthalmology Simon Dean said that had put huge pressure on their services, and wait-times were much longer than the nearby Auckland DHB's, where there had been considerable investment in eye services.
"In Manukau you tend to lose your driver's licence before you get cataract surgery, that's about where the cut-off is, whereas in Auckland you'll probably have the cataract operation before you lose your licence, so it's a subtle shift.
Dr Dean works at both Auckland and Counties Manakau DHBs and said he struggled to reconcile the difference between the two.
"At Auckland there has been some investment in staffing and they've now got no people overdue for their follow-ups, whereas we've still got just around 4000.
"A couple of months ago that was 5000 so we are tracking in the right direction but that's a lot of people where we just don't know if they're safe or not."
Counties Manukau has been running a series of weekend clinics during May and June to deal with the highest risk patients and has managed to see more than 500 patients.
Dr Dean said he had treated a woman who was using a wheelchair because she had lost vision in both her eyes.
"The day after surgery she could get out of her wheelchair, her niece who was pushing her round, who was missing school, she could go back to school again, that was two lives that we could set free because she could see again."
But the appointment backlog isn't limited to Auckland.
Figures obtained from the Ministry of Health show that at the end of March, more than 14,000 people were overdue for follow-up eye appointments at DHBs across the country.
Of those, 2800 had been waiting double the intended wait time.
Andrew Simpson, chief medical officer at the Ministry of Health, said DHBs and the ministry were working hard to improve the situation.
"We do not accept it and the DHBs do not accept it."
Mr Simpson said the number of people nationally waiting 50 percent longer than expected had reduced from 10,000 last year to 3000 in the most recent figures.
"Clinicians have prioritised people that have needed to be seen most urgently," he said.
The growing waiting lists times became apparent two years ago and the minstry and the DHBs were working to make sure they didn't get back into the same situation again.
"We are not anticipating anyone to be going blind as a result of this situation."
He said increases in the older population and people with diabetes, combined with more treatment options, meant more people were seeking treatment.
Hamilton ophthalmologist Stephen Ng said that was because patient numbers were increasing but resources were not.
"The number of people with eye problems has been growing at a very high rate because of diabetes and the aging population," he said.
College of Ophthalmologists chair Brian Kent Smith said the Ministry of Health last year gave DHBs $2 million to help manage the backlog - but more was needed.
"There's certain low-hanging fruit that you can harvest, you can train nurses to do certain things you can improve your efficiencies, but there's only so much you can do with a given budget.
"At some point you need a bigger budget to deliver a bigger service."
Dr Kent Smith said a report by Ernst and Young, commissioned by the Ministry of Health to look into ways eye services could be improved, was completed two months ago.
He said the college has yet to see the report, but believed it had been passed onto the Health Minister David Clark, who had yet to release it.