Children in focus

OT  speaks to Lisa Donaldson about delivering sight tests, spectacles, eye care education and support to nine schools in the UK

Lisa Donaldson

Tell us about what you do

I have a dream job as clinical lead for SeeAbility’s Children in Focus campaign. Our team currently visits eight London special schools and a school in Manchester delivering sight tests, spectacles and eye care education and support including providing a detailed plain English report on every child’s visual abilities, limitations and support strategies. In addition to doing some of our clinical work, my role involves supporting our team of part-time optometrists and orthoptists and a full-time dispensing optician to deliver our model of care. Children who attend special school are 28 times more likely to have a serious sight problem, with nearly 40% needing specs and a high prevalence of high refractive error and visual processing problems (cerebral visual impairment). Despite this, about 40% of the children we see have no reported history of any eye care (the average age is 12) and only 8% have ever visited an opticians. 

I get to work with an amazing wider team too at SeeAbility who are as passionate as I am about raising awareness of the importance of good eye care for people with learning disabilities and seeing a properly funded special schools sight testing service available in every special school. 

Our service is also a research project under the guidance of Margaret Woodhouse from Cardiff University – we are now the biggest ever global study of children with a learning disability. 

What is your professional passion? 

I love working with children and adults with learning disabilities. Exploring the best ways to communicate and engage is exciting, challenging and incredibly rewarding. For example, discovering a child is -8.00 for the first time at the age of nine is not that unusual and is truly life-changing for them. Many of the children we work with have autism and signs of autism can be similar to those of poor vision so no one considers getting an eye test. In fact we frequently hear parents and teachers say 'you won't be able to test his eyes – he won't sit still can't talk.' Being in the familiar school environment and building the eye test into the day’s routine makes things less stressful for the children and means we can try again on another occasion if the child's been having a bad day or spread the test over more than one day to gain trust. 

I am passionate about SeeAbility's vision of making regular access to good eye care a reality for everyone with a learning disability. 

What are you most proud of?

In 2016, SeeAbility hosted a Task and Finish group to produce a framework for Special Schools Eye Care – it is endorsed by all the eye care professional bodies and recommends a routine annual eye test, including a refraction and eye health check for every child in their special school. We are now working to explore ways in which it can become a reality. 

What is the one thing you couldn’t live without? 

My retinoscope. It gives me so much information on the quality of the ocular media, how well a child can sustain accommodation or overcome low levels of hyperopia. There is a higher incidence of keratoconus in the learning disabled population and retinoscopy is the best way to pick it up early – really important in these days of collagen cross linking. And of course my retinoscopy result is what I rely on to prescribe for many of my patients. 

How do you manage a work/life balance? 

It can be hard to switch off at times and there is always more to learn and improve upon. I am fortunate to not have to work weekends and our clinics in schools can only run in term time so that works really well with family life. 

What do you do to unwind? 

Spending time with my family, cooking together and going for walks in the woods.

You have won the OT lottery: what are the first three things you would do with the £1m jackpot? 

My husband is an architect and would love to design us a home, a family holiday to India and lots of books. 

Have you booked your next holiday? 

Nothing booked yet – probably camping with the children and dog in France. Lots of open air cooking, long walks and swimming.