The role of eyecare professionals in low vision

Question 1

What is the definition of a low vision service?

Answer 1

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

Question 2

What three things do we consider in Low vision services?

Answer 2

-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

Question 3

What is a multidisciplinary team?

Answer 3

Where more than occupation is involved: eg teachers, nurses, optoms, eyecare liaison officers

Question 4

what 11 things can be provided by the low vision service?

Answer 4

-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

Question 5

what are the 16 components of the low vision service (may not need to know this it was an included diagram in the lecture)

Answer 5

-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

Question 6

how does the low vision service help with emotional support?

Answer 6

via counselling+ structured therapy

Question 7

how does the low vision service help with visual function assessment?

Answer 7

-VA, contrast sensitivity and reading performance, visual fields, colour vision

Question 8

how does the low vision service help with low vision aids?

Answer 8

-prisms, optical aids: magnifiers+telescopes,electronic vision enhancement, non-optical aids, lighting

Question 9

how does the low vision service provide low vision training?

Answer 9

-eccentric viewing, head and eye scanning for field loss,use of complex aids

Question 10

what resources can the low vision service provide?

Answer 10

• gadgets for ADL

Question 11

what sensory subsititution does the low vision provide help with?

Answer 11

• BRAILLE, orientation / mobility training, ADL (activities of daily living)

Question 12

what Opthalmological care can the low vision service help to provide?

Answer 12

• DIAGNOSIS, TX AND MONITORING, ocular IMAGING, SI or SSI registration

Question 13

what optometric care can the low vision service help to provide?

Answer 13

-refracton, dispensing of specs

Question 14

what social care can the low vision service help to provide?

Answer 14

• home environment, selfcare , benefits

Question 14

what employment help is the low vision service able to help with?

Answer 14

• access to work schemes

Question 15

what educational help is the low vision service able to help with?

Answer 15

-apecial/mainstream provision

Question 16

where do we find low vision services in the UK?

Answer 16

-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

Question 17

What is the typical low vision pathway for an adult?

Answer 17

High street optom-GP- Hosp LV Clinic- Social services
ANOTHER ROUTE:
GP- HES LV clinic-social services

Question 18

what is a disadvantage of the typical low vision pathways available for adults?

Answer 18

waiting lists for LV clinic + Social services tend to be long (even upto 4-6 months)

Question 19

who are the ONLY group of people that can certify a person as SSI Or SI?

Answer 19

Consultant Ophthalmologists

Question 20

what can Optometrists do while px is waiting for referral into LV services?

Answer 20

as waiting time can be long- refer to charity- eg macular society or rnib helpline, or any other local charity

Question 21

What is the Typical Low vision pathway for a child?

Answer 21

GP-Child Development Unit (paediatrician, educational psychologist, physiotherapist, occupational therapist, social worker)-Other appropriate sources of help

Question 22

what service can help a child with low vision?

Answer 22

SENCO

Question 23

What is the Statement of Needs?

Answer 23

given to child so that they can be referred quickly into LV clinic- examples of child work and teacher can be bought along

Question 24

why are low vision services/pathways so important?

Answer 24

-many people unaware of them - many people don't get help they need stats on lecture

Question 25

what was the 2003 proposed pathway (Department of Health)

Answer 25

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)

Question 26

what was the 2018 proposed pathway for low vision?

Answer 26

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

Question 27

two limitations of 2018 proposed pathway for low vision

Answer 27

may not occur everywhere longer waiting times

Question 28

7 benefits of having a low vision pathway

Answer 28

-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

Question 29

one disadv of low vision service in UK compared to Wales

Answer 29

-can’’t give free nhs low vision aids in community setting in uk, wales you can

Question 30

Welsh Low Vision Scheme

Answer 30

-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

Question 31

what is a Welsh Vision passport?

Answer 31

Vision passport-all info about px, and all the different aids that have been dispensed to the px, and advice to px

Question 32

What groups of ppl are involved in The Low vision, habilitation and rehabilitation service team ?

Answer 32

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

Question 33

what are the 2 types of carers in low vision services

Answer 33

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

Question 34

can Optoms every decide if someone is SI or SSI?

Answer 34

in some hospitals can decide whether someone is SI or SSI-cvi form preseigned by consultant

Question 35

what is Vision 2020 (UK)?

Answer 35

Group with objectives to minimise VI in the UK

Question 36

What were the objectives of Vision 2020 (uk)?

Answer 36

-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

Question 37

were all the objectives of Vision 2020 UK met?

Answer 37

nope

Question 38

list some VI related charities/key contacts we should be aware of

Answer 38

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

Question 39

List some models of VI services elsewhere in world

Answer 39

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

Question 40

not a q there are some case study qs in slide 21 to do...

Answer 40

so go do them