Mrs Smith is 73 years old and attended the Eye Clinic at Rotherham General Hospital for the first time in November
2009. She has dry Age Related Macular Degeneration, first diagnosed in 2000. Her sight deteriorated over time and in
2004 she was registered as partially sighted.
In 2005 Mrs Smith moved to Rotherham to be closer to her family. She is married to George who is 77 years old. They live in sheltered accommodation where the warden looks in on them daily. Prior to this they ran a small guest house in
Blackpool and had done so for 25 years. As Mrs Smith’s vision deteriorated both her and her husband decided that the guest house was too much for them to cope with and they sold their home and business to move back to
Rotherham to gain additional support from their family. Mrs Smith is leaving behind her friends of 25 years, social clubs and activities and is worried that she will become more dependant on her family and become more socially isolated.
In 2006 Mrs Smith also had a triple heart bypass and suffers from asthma and arthritis. At her first visit to the Eye
Clinic at Rotherham the consultant confirmed that her vision had deteriorated further. He informed Mrs Smith she could benefit from cataract surgery and advised of increasing registration to Severely Sight Impaired. After delivering this news to Mrs Smith the consultant referred her onto the ECLO.
Mrs Smith was trying to remain very positive about the situation. This was her first visit to the Eye Clinic and already she had been told that her vision had worsened and she could need some surgery to remove cataracts. She found this was a lot of information to absorb at one time and her body language showed her concerns.
To alleviate some of her fears the ECLO reassured Mrs Smith of the situation and allowed her some time to gather her thoughts and ask any questions, over a cup of tea. Mrs Smith was more concerned about losing her vision altogether and not being able to see anything. The ECLO provided a high level of emotional support at this point, listening and empathising with Mrs Smith’s situation. Having some time to talk things over with the ECLO allowed Mrs Smith a few moments of contemplation to take on board her thoughts and feelings.
The ECLO provided information on Cataract surgery in the form of booklets in large print and on audio cassette which
Mrs Smith could take away with her. This material would provide a good understanding of what is involved in the operation allowing Mrs Smith the opportunity to make an informed decision about Cataract surgery, and whether the procedure was right for her.
At this point the ECLO could tell that Mrs Smith needed time to digest the information she had. Rather than discuss all options available at that time the ECLO explained the CVI registration process and made another appointment in 1 weeks time for Mrs Smith to come back to see the ECLO to discuss her options.
When Mrs Smith and her husband had left, the ECLO proceeded to complete the necessary CVI and referral form to the local visual impairment team in order for them to receive and process the information in a timely manner.
A week later Mrs Smith returned with her husband to see the ECLO. After listening to the tape she had made the decision to have Cataract surgery. She understood the implications and that this may mean not having an improvement in her vision, but had discussed this with her husband and decided to give it a chance. The ECLO referred Mrs Smith to the consultant’s secretary who made an appointment for the following week to have surgery to remove the Cataract.
Mrs Smith had made a short list, with the help of her husband, of all the things she felt she was no longer able to do.
These included preparing meals from scratch, operating the oven, housework such as cleaning and ironing and reading. The ECLO conducted a short assessment asking relevant questions regarding Mrs Smith’s ability to cope with mobility issues, self care needs, daily living skills, communication problems, financial issues, carers needs and support from family and friends. From this assessment the ECLO was able to give advice, information and guidance about the types of support available to Mrs Smith.

Mrs Smith was finding preparing meals from scratch very difficult. She was unable to cut foods items safely, tell if vegetables were washed and clean, set the oven to the correct temperature and tell if the food was correctly cooked.
In addition her communication problems wouldn’t allow her to read labels on foods or check sell by dates. With this in mind the ECLO advised of the local Resource Centre at Green Lane. The centre offers advice and information on a wide range of topics, covering all aspects of blindness and partial sight. Activities include information and registration days, craft courses, support groups and advice on the use of low vision aids. Training at the centre is also available for kitchen skills and safe food preparation. Having explained this to Mrs Smith she was very happy that support was on offer. The ECLO made the appropriate referral onto Green Lane through Social Service VI Team.
Communication problems w ere causing Mrs Smith a great deal of stress. She felt she had become a ‘hermit’ since her vision loss. She enjoyed bingo but couldn’t see to read the numbers on the cards, she enjoyed crosswords but the writing was too small for her to fill in the blank boxes correctly. The ECLO gave information on large print items such as crossword books and their availability from local shops in the town centre. As Mrs Smith lived in sheltered accommodation she played bingo at the local centre. With Mrs Smith’s permission the ECLO rang the warden services and spoke to the local housing warden in Mrs Smith’s area. The ECLO asked if bingo cards were available in large print and could these be provided for Mrs Smith. The warden was happy to provide this for Mrs Smith to ensure she continued to come to the centre on a regular basis allowing her to interact with others and be less socially isolated.
In addition the ECLO discussed how the visual impairment team could provide continued support to Mrs Smith through their Rehabilitation Officers (RO). The ECLO explained about the five main areas which they work in, referring to the earlier assessment. To enable Mrs Smith to continue with independent living an important part of this is the ability to get around freely and safely, both in and outdoors. The ECLO gave advice on how the RO’s can help with mobility training, which includes safe techniques to move around indoors and outdoors, familiarising a person with an indoor area, use of mobility aids and specific route travel and mental mapping skills. In addition they can provide help with marking cookers, organising work surfaces, safe and efficient ways of preparing food and pouring hot liquids including the use of aids and gadgets and systematic cleaning techniques.
Mrs Smith left the appointment saying she felt more confident about her outlook and although her sight couldn’t be improved that there was support and advice available to help her remain independent and safe.
Mrs Smith could draw upon a range of supported services for many aspects of her lifestyle within her local area through the ECLO including emotional support. Although the services are accessible to anyone who has a visual impairment not all of the services have the ability to reach each person on an individual basis.
The benefit of the ECLO on this occasion is
to provide a seamless service to patient through one referral process
improved screening process and assessments to enable early intervention
reduction of anxiety and depression in the patient
Patient and carer feel better informed about their situation and services available.
Patient is less distressed at the time of the first social services visit.
Closer relationship between agencies to ensure continued development of service provider and resources
More likelihood of early referrals from the eye clinic to social services. Therefore reducing the need for patients to return to the eye clinic for anything other than medical treatment.
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Provide supporting information with all CVI’s sent to social services to enable the establishment of eligibility criteria and prioritise the need for assessment.
Initial emotional support and referrals to formal counselling services if required.
Information is provided about local and national services.
Individuals are able to access statutory and voluntary services of their choice.
Provision of information in accessible formats. For example large print audio tape etc.
Time and information to deal with registration