Low Vision Services

Jenny LindsayCo-Deputy Head of OptometryBelfast Health and Social Care

Trust

Definitions A person with low vision is one who has an

impairment of visual function for whom full remediation is not possible by conventional spectacles, contact lenses or medical intervention and which causes restriction in that person's everyday life.

A low vision service is a rehabilitative or habilitative process, which provides a range of services for people with low vision to enable them to make use of their eyesight to achieve maximum potential.

(Low Vision Services Consensus Group Document, 1999)

Epidemiology N. Ireland has an ageing population Visual impairment increases with age

0-15yrs, 7/100,000 population reg B or PS 75-84yrs, 431/100,000 population reg B or

PS 85+yrs, 946/100,000 population reg B or PS(Evans et al, 1995 and 1996)

48 000 people with visual impairment in N. Ireland (NISRA)

Standards 1 (DOH, 2007) Multi-disciplinary, multi-agency approach

(health, social care and voluntary providers) Flexible and able to meet the needs of those

with additional disabilities e.g. learning disabilities

Accessible (referral and location) Personnel suitably trained or undergo training

programme leading to accreditation Service improvement, monitoring and

evaluation of the service – include user opinions

Standards 2 (DOH, 2007) Comprehensive range of services –

Functional visual assessment Range of optical, non-optical and

electronic aids available Training and/or therapy Links to other services (home

assessment and mobility, education and employment services)

Access to support, advice and counselling

Service models “Traditional” hospital optometry low vision

clinic “One stop shop” e.g. Birmingham Focus, RNIB

Judd Street, Gateshead Community model e.g. Welsh Low Vision Scheme

Main advantage is ease of access More challenging cases difficult to manage Initial set-up and accreditation

To date no reliable research to compare outcomes or cost-effectiveness with different models

Northern Ireland 2 bases Royal Victoria Hospital and Altnagelvin

Area Hospital Outreach services at 12 other locations

throughout N. Ireland Weekly clinic at University of Ulster, Coleraine Joint optometric and rehabilitation assessments Wide range of visual function tests and low

vision aids 67% of LVAs loaned at initial appointments are

illuminated stand magnifiers and 63% ≤x5 magnification (Lindsay et al, 2004)

Benefits and Challenges 69% use LVAs regularly, 96% benefited

from rehab support and 96% overall reported benefit from attending the LVC (Lindsay et al, 2004)

Number of LVC appointments risen from 2500 to 5000 in last 10 years

Waiting times 6 months in some locations

Future – do we extend current service or look at alternative ways of providing low vision services?