an overview of the welsh low vision service barbara ryan, tom h margrain, john m wild cardiff school...
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![Page 1: An overview of the Welsh Low Vision Service Barbara Ryan, Tom H Margrain, John M Wild Cardiff School of Optometry and Vision Sciences, Cardiff University,](https://reader030.vdocuments.us/reader030/viewer/2022032705/56649dd95503460f94acf7d8/html5/thumbnails/1.jpg)
An overview of the Welsh Low An overview of the Welsh Low Vision ServiceVision Service
Barbara Ryan, Tom H Margrain, John M Wild Barbara Ryan, Tom H Margrain, John M Wild Cardiff School of Optometry and Vision Sciences, Cardiff School of Optometry and Vision Sciences,
Cardiff University, WalesCardiff University, Walesandand
Richard N RobertsRichard N RobertsThe National Assembly Government, WalesThe National Assembly Government, Wales
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Survey of low vision services in the UK
Ryan and Culham 1999RNIB and Moorfields Eye Hospital
• services patchy and fragmented
• provision not in areas of highest prevalence
• people having to travel long distances
• waiting times up to a year
Fragmented Vision
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Our better vision
Users views sought in twenty focus groups followed by a questionnaire
• people found low vision services a positive experience but difficult to access
– not automatically referred– long waiting times– difficult to get to
Ryan and McCloughlan 1999RNIB and Herriot-Watt University
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•prevalence of visual impairment in Wales is nearly 10% higher than in the UK
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Survey in Wales
Furze, Margrain and Wigham 2001Cardiff University
The main problem with low vision services in Wales was access to the service:- restricted by a convoluted referral route
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Optometrist
GP
Ophthalmologist
Low Vision Service
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Survey in Wales
Furze, Margrain and Wigham 2001Cardiff University
The main problem with low vision services in Wales was access to the service:- restricted by a convoluted referral route - waiting times in some parts of Wales were 18 months
![Page 9: An overview of the Welsh Low Vision Service Barbara Ryan, Tom H Margrain, John M Wild Cardiff School of Optometry and Vision Sciences, Cardiff University,](https://reader030.vdocuments.us/reader030/viewer/2022032705/56649dd95503460f94acf7d8/html5/thumbnails/9.jpg)
Survey in Wales
Furze, Margrain and Wigham 2001Cardiff University
The main problem with low vision services in Wales was access to the service:
- geographical distribution of services frequently required people to travel 100 miles or more (round trip)
![Page 10: An overview of the Welsh Low Vision Service Barbara Ryan, Tom H Margrain, John M Wild Cardiff School of Optometry and Vision Sciences, Cardiff University,](https://reader030.vdocuments.us/reader030/viewer/2022032705/56649dd95503460f94acf7d8/html5/thumbnails/10.jpg)
Welsh Low Vision Service
• primary care (optometry practices)
• all Wales
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Welsh Low Vision Service
• started in July 2004
• funded by The Welsh Assembly Government
• co-ordinated administratively by Carmarthenshire Local Health Board (LHB)
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– close to home– waiting time less than 2 weeks– referred by:
• GP • social services• voluntary sector• ophthalmologist• teacher• optometrist• friend• self
Ease of Access
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Practitioners trained and accredited byCardiff University.
– web-based theoretical modules with on-line MCQs
– practical training sessions– practical assessment
Training and Accreditation
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Assessment equipment supplied
• LogMAR distance Visual Acuity Chart• Pelli- Robson Contrast Sensitivity Chart• LogMAR Kay Picture Chart• Bailey-Lovie Near Acuity Threshold Chart• McClure Reading Test type (white)• +/- 0.75 cross cyl• +/- 1.00 cross cyl• pair of Halberg clips
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Low vision aids
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• standard record card used
• following an assessment faxed to
Carmarthenshire LHB
• key data entered onto database and order
generated.
• LVAs sent to practice and issued on loan
• all appointments and LVAs are free to
people using the service
Process
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Holistic– Work closely with other established local
services (secondary care, social services, education, employment, voluntary)
– Vision Passport•Share information•Empowerment
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Holistic
– rehabilitation workers given additional training in low vision therapy
– Children’s Low Vision Advocate
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First 6 months
•105 primary eye care professionals accredited (about ¼ of those in Wales)
•95 optometrists; 9 dispensing opticians; and 1 ophthalmic medical practitioner
• providing the service in 121 practices
• 1161 people assessed in first 6 months
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• warmly received by people using
the service and linking with it
• waiting times for majority, less
than 2 weeks
• another 85 practitioners currently
training
Early indications
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• in many areas boundary between health and social services have been removed
• earlier access to social services
• children receiving low vision assessments in Wales for first time
Early indications
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Future
For the foreseeable future everyone in Wales who needs to will be able to access a low vision service within a couple of weeks which is:
• close to their home;
• in well equipped practices;
• provided by trained and accredited staff; and
• with good links other local services
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The effectiveness of the service is being constantly
monitored:
– cost
– waiting times
– distance travelled
– prescribing rates
– referrals
– measure of effectiveness
The service will continue to evolve to meet the needs of
people using it
Future