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Useful for UNIT 8 > Low Vision Epidemiology Parts 1 & 2 > Flashcards

Low Vision Epidemiology Parts 1 & 2 Flashcards

1
Q

What is visual impairment?

A

Reduced binocular visual acuity, which cannot be improved even with best optical correction provided by conventional lenses
- also needing more than +4DS of near add is classed as visual impairment

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2
Q

Why is it important to define visual impairment?

A

For financial benefits and social help we can offer the px

For epidemiological studies

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3
Q

What other terms may you hear to define visual impairment?

A

Partial Sight’, ‘Low Vision’, ‘Subnormal Vision

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4
Q

When determining whether someone has a visual impairment do we base the status off the best or worst acuity eye?

A

They are only visually impaired if vision from their best eye is below 6/18

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5
Q

What is near vision impairment?

A

Near vision worse than N6 or N8 at 40cm and best corrected visual acuity better than 6/12 (20/40, 0.5)

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6
Q

What are the two categories of visual impairment in the UK?

A 
Severely Sight Impaired (previously referred to as ‘Blind’)
Sight Impaired (previously referred to as ‘Partially Sighted’)
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7
Q

How does the national assistance act describe blindness?

A

‘So blind as to be unable to perform any work for which eyesight is essential’
(No reference to near vision, an individuals occupation or other disabilities)

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8
Q

What are the guidelines for categorising someone severely sight impaired?

A

Having either :
Acuity below 3/60
Acuity better than 3/60 but below 6/60 with significantly contracted field
Acuity better than 6/60 but with substantially contracted fields especially inferiorly

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9
Q

What are the guidelines for being sight impaired?

A

No legal definition.
Substantially and permanently handicapped by defective vision caused by congenital defect, illness or injury
3/60 to 6/60 with full field
Up to 6/24 with a moderate restriction of the field, opacities or aphakia
6/18 or better with a gross field defect

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10
Q

Why may aphakic people be categorised as sight impaired?

A

As they have no lens ( normally following cataract surgery) they would require high positive prescription (over +10DS) - this significantly reduces their field of view allowing them to be placed in the sight impaired category (if vision is only as good as 6/24).

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11
Q

What are examples of pxs that might have a gross field defect?

A

Pxs with strokes (hemianopia) , pxs with advanced glaucoma, px with retinitis pigmentosa, etc,

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12
Q

What are the guidelines for classifying a child with visual impairment?

A

Children, ‘unless obviously Blind’ should always be classified as sight impaired
At the age of 4 years and over binocular VA should be used
Children with VA of 6/24 or better should be considered candidates for mainstream schooling.

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13
Q

In order for visually impaired individuals to be prioritised and receive help they must be registered - what form do they have to voluntarily therefore fill in?

A

Certificate of vision impairment (CVI)

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14
Q

What is a Low Vision Leaflet? when, why and how is it used?

A

A low vision leaflet is a leaflet for those that don’t quite meet the requirements of being visually impaired yet would like to receive help as they are struggling. As a result it is used in primary care clinics. It relies on the px themselves filling in the form and is a means of self referral.

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15
Q

What px may really struggle with vision but not meet the requirements to be classed as visually impaired?

A

Pxs with AMD as although their VA may be be technically up to scratch, distortion of lines causes a big effect on the quality of their life.

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16
Q

True or False- The Low vision form can be used to certify an individual has a visual impairment

A

False - the only form that can certify that someone has a visual impairment is the Certification of Visual Impairment form.

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17
Q

When should a referral of visual impairment be made to social services?

A

As soon as a lack of social needs being met become apparent

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18
Q

Who registers (not diagnoses) a px to be either Sight Impaired or Severely Sight impaired?

A

Social services

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19
Q

Who can diagnose an individual to be sight impaired (SI) or severely sight impaired (SSI)?

A

Only an ophthalmologist or consultant may (optoms cannot)

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20
Q

True or False - Whilst registration as being visually impaired is optional, the council has a legal compulsory obligation to help out anyone who is visually impaired.

A

True - however, this can take time - you are more likely to be prioritised if you are registered.

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21
Q

What is the point of formally certifying people as SI or SSI?

A
  • provides a pathway for someone with sight loss to be brought to the attention of social services.
  • epidemiological analysis provides information on the prevalence of visual impairment.
22
Q

True or False - Social services are required to keep a register of visually impaired people

A

True - Care Act 2014 requires local authorities to establish and maintain a register of people who are sight impaired or severely sight impaired

23
Q

What can a certificate of visual impairment look like?

A

A four part form - describing px details, extent of their vision , relevant underlying diagnosis, additional info about their living conditions , consent to information sharing and ethnicity as well as driving info.

24
Q

Who gets a copy of a certificate of visual impairment?

A 
Patient
Hospital
General Practitioner
Local council/Care Trust
Epidemiological analysis @ Royal College of Ophthalmologists Certifications office at MEH
25
Q

How does a referral of visual impairment (RVI) leaflet differ from a low vision leaflet (LVL)?

A

RVI is done by hospital LVL is self done.

RVI includes an urgency of referral section.

26
Q

What are the benefits specifically of a severely sight impaired (SSI) person getting registered?

A

Blind person’s personal income tax allowance
Reduction of 50 per cent on the television licence fee
Car parking concessions: the Blue Badge Scheme for whomever drives them everywhere
Free postage on items marked “articles for the blind”
free permanent loan of radios, cd radio cassette players.
help with telephone installation charges and line rental.

27
Q

What are the baseline benefits of anyone registered as visually impaired?

A 
Free NHS sight test
Other NHS costs
Discounted rail travel
Local bus schemes
Exemption from BT Directory Enquiry charges
Information in accessible formats
Leisure concessions
Council tax disability reduction
Welfare benefits
Attendance Allowance
Disability Living Allowance
Carer's Allowance
Employment and Support Allowance
Tax Credits
Pension Credit
Housing Benefit and Council Tax Benefit
Help from specially trained social services staff, usually called Rehabilitation Workers or Rehabilitation Officers
Protection under the disability discrimination act
28
Q

Whom does the access to work scheme apply to?

A

Anyone with a disability - being sight impaired counts as a disability

29
Q

What is the point of the access to work scheme?

A

Assist disabled people by providing practical support and helping to meet additional costs associated with overcoming work related obstacles resulting from disability

30
Q

What are examples of things that can be done for a visually impaired person through the access to work scheme?

A

Adaptations to Premises and Equipment. E.g. Zoom text for Computer
Special Aids and Equipment. E.g. CCTV
Travel to Work. E.g. Cost of a taxi if applicable
(Majority of this cost is covered by the scheme).

31
Q

Does a visually impaired child need to be registered in order for help to be offered toward them?

A

NO - Children’s Act 1998/2004 states Help should be available to all ‘children in need’

32
Q

What is the system in place to help visually impaired children?

A

Local Education Authorities identify all children recognised with special educational needs from age of 2 (up to age 19 if they are in full time education)
as well as support from SENCO

33
Q

What is SENCO?

A

special educational needs coordination officer

34
Q

What is an ECLO?

A

eye care liaison officer

35
Q

Define epidemiology

A

‘The study of the distribution, determinants and control of disease in human populations’

36
Q

Define prevalence

A

Measure of disease frequency
Number of people out of total population with a disease, at a given time
Typically expressed in terms of a proportion usually %)

37
Q

Define incidence

A

Number of cases occurring in a specified time
Sometimes expressed as a rate: the number of new cases occurring over a given time frame in relation to the total number of persons at risk during the same time frame

38
Q

How do we calculate incidence?

A

No. of new cases over a given time interval divided by Total population succeptible at the beginning of the specified time

39
Q

True or False - women are more likely to be visually impaired?

A

True - Of the 253 million people in the world who are visually impaired
55% are women (139 million).

40
Q

True or False - pxs over 50 are more likely to be sight impaired compared to their younger counterparts

A

True - . 203 million, representing 80%, are aged 50 years or older.

41
Q

What are global causes of blindness?

A 
Cataract: 25.8%
Refractive Error: 48.99%
Glaucoma:2.78%
Age Related Macular Degeneration: 4.10%
Corneal Opacities:1.65%
Diabetic Retinopathy: 1.16%
Trachoma:0.79%
Other: 14.71%
42
Q

Why is Diabetic retinopathy the only cause of global blindness in which there has been an increase in prevalence?

A

Because prevalence of diabetes itself has increased.

43
Q

True or False - the global incidence of blindness varies with age

A

True

44
Q

What are the risk factors for sight loss in the UK?

A 
Old Age
31 per cent aged 85 years and over
Low Income
Diabetes
Smoking
Learning Disabilities
Ethnic Minority Groups
Other health conditions
45
Q

What are children with a visual impairment likely to suffer with/have?

A

Around half have additional disabilities and/or special educational needs

46
Q

True or False - there are more visually impaired adults than children in the UK

A

True

47
Q

Why is there such big discrepancies between percentage causes of visual impairment in the UK compared to globally?

A

In the UK there is a good access to measures such as glasses which mean percentage cause of refractive error as a cause of visual impairment is significantly lower.

48
Q

What are the common causes of visual impairment in adults in the UK?

A 
Age Related Macular Degeneration (40%)
Glaucoma (30%)
Diabetic Retinopathy (8%)
Other less common causes
Cataract
Myopia
Optic Neuropathies
49
Q

What is the biggest three causes of visual impairment in the UK ? ( in order)

A

1- AMD
2 - Glaucoma
3- Diabetic Retinopathy

50
Q

What are common causes of visual impairment in children in the UK?

A

Cerebral Visual Impairment 39%
Hereditary Retinal Disorders 22%
Optic Nerve pathologies 22%
Congenital Cataract 4%

51
Q

What is the disadvantage of using data from councils about number of visually impaired people in the area?

A

Registration is voluntary and so the number is an underestimation.

52
Q

True or False - High myopia can cause visual impairment

A

True

Useful for UNIT 8 (4 decks)

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