what to do when sight loss...
TRANSCRIPT
What to do when sight
loss occurs?
Helen May
RNIB Eye Health Advisor
Optometrist
Sight Loss Prevention Team
Introduction
Who are RNIB?
• UK charity
• Patient Voice organisation
RNIB Priorities:
• Prevention of unnecessary sight loss
• Supporting independent living
• Creating an inclusive society
Sight Loss Prevention
Reducing preventable sight loss is a key priority
• Public Health
• Commissioning eye and supporting services
• Addressing health inequalities
• Collaborative working
• Evidence building - data and resources
Sight Loss Data Tool
• Local, regional, national data on diabetes
• No of people with diabetes and diabetic retinopathy
www.rnib.org.uk/aboutus/research/statistics/pages/sight-loss-data-tool.aspx
Sight Loss Prevention
Campaigns scoping work:
• Aware of delays in treatment/referrals
• Problems with capacity
• Implementation of NICE DMO guidance
• Advocate for patients to access timely treatment
• Support clinicians and professionals
• Confidential and anonymous
Sight loss & health inequalities evidence
Community Engagement Projects
Community Engagement Projects (CEP)
DRS Barriers:
• Difficulty of managing all the appointments associated
with diabetes
• Limited understanding of how diabetes can cause
diabetic retinopathy
• Some confusion about the need for both DRS and eye
examinations
DRS Enablers/High satisfaction:
• timely notification of appointments
• minimal waiting time
• polite staff
CEP: Interventions
1. Increase uptake of DRS
• DRS reminder appointments sent via text message
2. Increase attendance at secondary care
• Targeted telephone reminders conducted by a
bilingual worker
3. Increase uptake of eye examinations.
• Health professionals providing key messages
• Community education campaign
4. Increase understanding of eye health and its
relationship to diabetes
• Implementation of a self-care tool for diabetic people
• Community engagement and awareness raising via eye
health champions and volunteers
Understanding diabetic eye conditions
Cyflyrau llygaid sy'n gysylltiedig â diabetes
Sight Loss in Diabetes
Reduction in the 'sharpness' of vision (visual acuity)
Loss of side or central vision (visual field)
Difficulties to detect contrast and seeing colours ('washed out')
• Face/Coin recognition
• Reading medicines & food
• Reading correspondence
(miss appointments/bills)
• Mobility difficulties
• Watching the TV
• Work
• Bus numbers
Impact of sight loss
• Emotional impact
• Loss of independence
• Lack of privacy
• Lack of support
• Reduced quality of life
• Risk to health
• Mobility
• Reading
• Falls
• Anxiety
• Social Isolation
Importance of Early Support
To help keep the patient safe, independent and reduce social isolation
Risk of depression in the elderly:
"Older people with sight loss are almost three times more
likely to experience depression than people with good
vision." (Evans, Fletcher and Wormald, 2007)
Important to acknowledge and treat otherwise all other
intervention may be of limited benefit
Where to now?
Help and support:
• Emotional support • Eye Clinic Liaison Officer (ECLO) • Emotional Support • Low Vision service • Rehabilitation services (social service) • Employment support • Education/children's service • Finance • Housing • Information and signposting • Local/national groups for people with visual impairment
Bigger, Brighter, Bolder
Making everything BIGGER: Easier to see
• Larger objects/larger print
• Magnifiers
• Moving closer to objects
BRIGHTER: Lighting
•Thomas Pocklington Trust
BOLDER: High Contrast
• Highlight Step edges
• Pencil v felt pen
Other considerations and aids
•Glare shields/ Hats with a brim
•White canes/ Mobility training
•Blister packs for medication
•Assistive gadgets
•Talking clocks, BP and blood sugar monitors
•Adaptations for insulin pens
•Talking books
•Assistive technology
•Kindles/iPads
•Befriending services
•Certification (CVI) and Registration
Certification and Registration
Certificate of visual impairment (CVI)
• Officially documents someone's vision loss
Registration
• CVI sent to the local authority and the patient is added
to the visual impairment register
Benefits:
• Access to local social services sensory team
• Access to work
• Travel discounts and support
• Reductions in council tax/Apply for other financial
benefits can be applied for
Importance of Certification
• Accessing social services sensory team and access to
work (Due to financial cuts)
• Enables the patient to become aware of the support
available to them
• Plan future health care services/social
services/education service provision
• Better understanding of eye care risk factors
• Does not reflected badly on the clinical success rating
of the hospital
• Delayed certification due to active treatment?
• Criteria for CVI states 'generally'
• LVL and RVI use?
Low Vision: Accessible DRS
Clinic:
• Layout of rooms
• Lighting of rooms
• Contrast of table edges
• Guiding into assessment room
Accessible information
• Appointment letter
• Results letter
Other:
• Signing consent forms Black felt pen
• Transport/Mobility
Action Mobile Resource Centre
• Information and signposting
• Daily living aids: talking clock, watches,
• Kitchen equipment, household products, DIY gadgets
• Daisy players for talking books
• Adaptive hard and software for computers
• CCTV magnifiers
Action Low Vision Centre (C&I)
Integrated low vision service for adults
Specialist clinic for people with learning disabilities
Rehabilitation (social services)
Low vision aids/Non optical aids
Direct links with:
• Emotional support
• Independent living coordinators
• Computer assistance
• Resource centre
• Other sight loss charities
• HES/GP
© RNIB 2011
Registered charity number 226227
Helen May
Eye Health Advisor
Telephone: 020 7391 2369
Email: [email protected]
Website: www.rnib.org.uk/healthprofessionals
RNIB Helpline Number: 0303 123 9999
Action Low Vision Clinic: 020 7391 2241
Contact Details