The role of eyecare professionals in low vision Flashcards
What is the definition of a low vision service?
Taken from ‘Recommended Standards for Low vision standards’:
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 best use of their eyesight and visual function to achieve maximum potential
What three things do we consider in Low vision services?
-not just about the prescribing of gls and/or magnifiers
-need to consider the use of multi dislplincary teams/ multi disciplinary agencies (eg mac society and social services)
-deal with the whole person: include impairment but also how this limits everyday activities, disability and interaction with society
What is a multidisciplinary team?
Where more than occupation is involved: eg teachers, nurses, optoms, eyecare liaison officers
what 11 things can be provided by the low vision service?
-referral for diagnosis and surgical treatment
-referral to low vision services (HES) but also for: low vision aids, best optical correction, assessment of functional vision - example measuring visual acuity, reading speed, contrast sensitivity etc
-referrals and reminders for annual eye exams
-info about eye condition
-Registration as SSI or SI
-Info about services eg info on mac society
-assessment of Needs and understanding limitations
-emotional support+ counselling referral
-Provision of daily living and mobility aids and training (home, school and work environments)
-Changes to the environment- be it at work or from school
-Continued Support throughout whole journey from the start
what are the 16 components of the low vision service (may not need to know this it was an included diagram in the lecture)
-educational support
-employment services
-national charities
-local voluntary society
-social care needs
-optometric care
-Ophthalmological care
-sensory substitution strategies
-access to computers/IT
-Resource centre
-low vision training
-low vision aids
-visual function assessment
-explanation and information
-social/leisure/interest groups
-emotional support
how does the low vision service help with emotional support?
via counselling+ structured therapy
how does the low vision service help with visual function assessment?
-VA, contrast sensitivity and reading performance, visual fields, colour vision
how does the low vision service help with low vision aids?
-prisms, optical aids: magnifiers+telescopes,electronic vision enhancement, non-optical aids, lighting
how does the low vision service provide low vision training?
-eccentric viewing, head and eye scanning for field loss,use of complex aids
what resources can the low vision service provide?
- gadgets for ADL
what sensory subsititution does the low vision provide help with?
- BRAILLE, orientation / mobility training, ADL (activities of daily living)
what Opthalmological care can the low vision service help to provide?
- DIAGNOSIS, TX AND MONITORING, ocular IMAGING, SI or SSI registration
what optometric care can the low vision service help to provide?
-refracton, dispensing of specs
what social care can the low vision service help to provide?
- home environment, selfcare , benefits
what employment help is the low vision service able to help with?
- access to work schemes
what educational help is the low vision service able to help with?
-apecial/mainstream provision
where do we find low vision services in the UK?
-mainly HES (65%)
-Social services Department (6%)
-voluntary organisations (eg : Low Vision clinics- RNIB) (10%)
-Optometry practices (15%)- mainly in Wales
-Specialist Teachers (3%)
-University Eye Clinics (1%)- low vision clinics at city sight
What is the typical low vision pathway for an adult?
High street optom-GP- Hosp LV Clinic- Social services
ANOTHER ROUTE:
GP- HES LV clinic-social services
what is a disadvantage of the typical low vision pathways available for adults?
waiting lists for LV clinic + Social services tend to be long (even upto 4-6 months)
who are the ONLY group of people that can certify a person as SSI Or SI?
Consultant Ophthalmologists
what can Optometrists do while px is waiting for referral into LV services?
as waiting time can be long- refer to charity- eg macular society or rnib helpline, or any other local charity
What is the Typical Low vision pathway for a child?
GP-Child Development Unit (paediatrician, educational psychologist, physiotherapist, occupational therapist, social worker)-Other appropriate sources of help
what service can help a child with low vision?
SENCO
What is the Statement of Needs?
given to child so that they can be referred quickly into LV clinic- examples of child work and teacher can be bought along
why are low vision services/pathways so important?
-many people unaware of them
- many people don’t get help they need
stats on lecture
what was the 2003 proposed pathway (Department of Health)
patient referred to low visions service(leaflet or letter of referral)-patient attends lvs-px has follow ups as and when (this can be done over phone)
what was the 2018 proposed pathway for low vision?
1) referral:GP, HES OR self-referral
2)diagnosis: via consultant opthalmologist- CVI= SSI or SI
3)Early intervention: advice info and emotional support via eyecare laision officer or vision support service
4)registration+ assessment
5)early intervention- VI rehab programme
6)assessment of eligible need- community care assessment
7)social care support
8)independent living with full choice+control
two limitations of 2018 proposed pathway for low vision
may not occur everywhere
longer waiting times
7 benefits of having a low vision pathway
-reduce unnecessary referrals to the HES LV service
-reduce px anxiety and increase capacity within the overburdened hospital clinic
-more cost effective service if being treated in primary care
-high quality low vision assessment, information and clinical support
-can be given low vision aids (LVAs), daily living aids and follow-up in a community setting in a convenient location for them
-provide accredited theoretical training which supports the pathway
-less overburdened services= more frequent apts
one disadv of low vision service in UK compared to Wales
-can’’t give free nhs low vision aids in community setting in uk, wales you can
Welsh Low Vision Scheme
-Accredited Optometrists provide the service in the community
-Accreditation via Cardiff University
-No charge for the appointment.
-LVA are issued free of cost on loan
-Vision passport
-Referral via self referral, GP/Optometrist/Social Services/Community Services/Ophthalmologist
what is a Welsh Vision passport?
Vision passport-all info about px, and all the different aids that have been dispensed to the px, and advice to px
What groups of ppl are involved in The Low vision, habilitation and rehabilitation service team ?
Carers- there are 2 types
Dispensing Opticians
General Practitioners to hes,
Occupational Therapists
Ophthalmic Nurses- may be eyecare laision officer- bridge between hosp and social services- can dispense lva’s in hes liek DO’s- no refraction unless under ophthalmologist
Ophthalmologists
Optometrists
Orthoptists
Rehabilitation Workers/Officers-work in social services- sensory team- proide help in community and home setting- give orientation adn mobility training, also prvide training for electornic lva’s
Social Workers- mainly through rehab workers
Eye Care Liaison Officers (ECLOs)- bridge between hes and social care- can signpost to mac society
Specialist Teachers
-trained for children with VI
what are the 2 types of carers in low vision services
Informal carer- family and friends of px with visual impairment- just VI pxs, or paid carers- these are formal carers- tend to be for ppl with disabilities alongside VI
can Optoms every decide if someone is SI or SSI?
in some hospitals can decide whether someone is SI or SSI-cvi form preseigned by consultant
what is Vision 2020 (UK)?
Group with objectives to minimise VI in the UK
What were the objectives of Vision 2020 (uk)?
-To prevent avoidable blindness
-To improve the quality of services to vision impaired people
-To improve the training available to professionals providing advice and services
-To improve communication between organisations within the VI Sector
-To improve the availability of information to vision impaired people
-To ensure that the voices of the vision impaired are heard when planning services and their opinions sought on key issues affecting their lives
-To raise public awareness of the issues and problems relating to sight loss
were all the objectives of Vision 2020 UK met?
nope
list some VI related charities/key contacts we should be aware of
Charities- eg esme’s umbrella- charles bonnet’s syndrome,
the macula society,
retina uk
Glaucoma uk
Blind in business- young ppl- also in touch with access to work
Social Services Department-sensory service team? Rehab officers fo rVI?
Local HES-lv clinic? Where to refer px?
RNIB
Macular Society
Local Charities-Sutton vision, croydon vision-loads of local sight loss charities–eg training for elctronic lva’s, activities
Guide Dogs for Blind- list of services in local areas
List some models of VI services elsewhere in world
Sweden- referred to lv centres- free even electronic lva’s
Spain-charity mainly deals with
Netherlands - referred to lv centres- free even electronic lva’s
United States of America
-private duh
not a q there are some case study qs in slide 21 to do…
so go do them
