How do I…

Speaking to patients about sight loss

Optometrist and clinical researcher at the National Institute for Health Research, Jasleen Jolly, shares advice on communicating effectively with people with low vision sight loss

Jasleen Jolly

When a patient presents to an eye care professional and they are losing their sight, they are often very emotional, very distressed and have a lot of questions.

With low vision particularly, practitioners have one shot to get it right because research shows that whatever happens at that first appointment colours how that patient perceives you as a professional, as well as their entire experience of their vision loss going forward. Therefore, if you can turn something that is very negative into a positive experience, you can influence how well a patient is able to adjust to their vision loss, as well as how they are going to interact with you as a professional in all future consultations.

To ensure that the patient is as comfortable and as informed as possible, there are some practical steps practitioners can take when communicating with patients.

The dos

Always be empathetic when speaking to patients about their vision loss. Try to put yourself in their shoes and think about how you would feel in their situation – if you would not like to be talked over, do not talk over someone else, and if you would not want to be grabbed, guided or pulled around, do not do it to someone else. Make the patient feel supported.

You should also always ask and engage with the patient so they feel included in the consultation. In the past, a lot of patients have told me that when they were first given their diagnosis they were talked over, especially if they were given the diagnosis as a child. Patients can get irritated when the clinician speaks only to a parent or carer so I would encourage optometrists to engage with the patient, even if they cannot see you, and talk directly to them because they will be able to perceive that and understand you better.

The do nots

Practitioners should never tell patients that there is nothing we can do because there is always something we can do. It might not be medical therapy, but patients can be referred to support networks, to helplines, to charities or to local groups. As optometrists, we can also provide patients with low vision support, helpful pointers and tips, and we can signpost them to others services for information. Practitioners should never tell someone there is nothing they can do because all that does is kill hope.

I would also suggest practitioners try not to belittle the worries of individual patients because even if a patient has milder vision loss than the last patient you saw, they still have genuine concerns and you should therefore listen to them, respond to them and give them evidence-based research to help them understand their condition.