Low Vision Services
Jenny Lindsay
Co-Deputy Head of Optometry
Belfast Health and Social Care Trust
Definitions
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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
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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)
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48 000 people with visual impairment in N.
Ireland (NISRA)
Standards 1 (DOH, 2007)
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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)
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Comprehensive range of services –
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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
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“Traditional” hospital optometry low vision
clinic
“One stop shop” e.g. Birmingham Focus, RNIB
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Community model e.g. Welsh Low Vision Scheme
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Judd Street, Gateshead
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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
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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
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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?