Clinical Review

Improving healthcare access for people with visual impairment and blindness

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e542 (Published 30 January 2012) Cite this as: BMJ 2012;344:e542
  1. M E Cupples, clinical reader1,
  2. P M Hart, consultant ophthalmologist2,
  3. A Johnston, care co-ordinator3,
  4. A J Jackson, head of optometry2, head of clinical services4
  1. 1Department of General Practice, Queen’s University, Belfast BT9 7HR, UK
  2. 2Belfast Health and Social Care Trust, Belfast
  3. 3Royal National Institute for the Blind, Belfast
  4. 4Australian College of Optometry, Melbourne, Australia
  1. Correspondence to: Margaret E Cupples m.cupples{at}qub.ac.uk
  • Accepted 12 January 2012

Summary points

  • Visual impairment can have adverse consequences for health and wellbeing, and its prevalence is increasing, especially among older people

  • People with visual impairment are likely to have limited access to information and healthcare facilities, and to receive sub-optimal treatment because staff are unaware of specific needs related to vision

  • Being aware that people may have problems with vision is an important pre-requisite for good healthcare

  • Taking time to communicate effectively about access, facilities, diagnosis, and management plans is necessary; communications, in visual or audio format, should be tailored to individuals’ needs

  • Checking that personal resources are in place to facilitate compliance with treatment plans is essential for good clinical care

Worldwide, visual impairment is increasing in prevalence: current data indicate that 284 million people have impaired vision,1 10% of whom live in the developed world. In the UK sight loss affects about two million people,2 including an estimated 80 000 of working age and 25 000 children. The prevalence of visual impairment is higher among those with multiple disability and older people.3 According to estimates from the UK’s Royal National Institute for the Blind (RNIB) one in 30 people of any age, one in five aged 75 or over, and half of those over age 90 years in the UK are living with sight loss.4 Older people with vision impairment report greater difficulty performing activities of everyday living than those with other or no sensory impairments.5 Individuals with impaired vision may have great difficulty in accessing and negotiating healthcare services. We discuss the difficulties that visually impaired patients encounter in the healthcare environment and ways in which problems may be overcome.

Sources and selection criteria

The material for this article was based on discussion between an optometrist, an ophthalmologist, and a general practitioner, who were engaged in research exploring the needs …

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