How low vision services have evolved over three decades

Optometrist Dr Jane McNaughton delivered the annual Janet Silver memorial lecture on low vision at the Hospital and Specialty Optometrists Conference

Specialist optometrist at Leicester Royal Infirmary, Dr Jane McNaughton, delivered the CPD-accredited Janet Silver memorial lecture at the Hospital and Specialty Optometrists Conference (HSOC), hosted at the University of Warwick last month (November 4–5).

Entitled 30 years on from the urban low vision clinic – the changing habits of low vision practitioners, during the lecture McNaughton discussed how low vision services have changed since she entered the profession 30 years ago.

McNaughton told OT: “It was certainly quite different from what it is now.”

“We were very focused as optometrists within the hospital eye service on prescribing devices, but now it’s a more holistic approach,” McNaughton explained, adding: “We talk about aspects of services, the impact of sight loss, the functional impact of sight loss, and what we can do to assist.”

As a result of these changes, McNaughton is pleased that optometrists in low vision clinics are today working alongside other healthcare practitioners, in particular the vision rehabilitation sector, “which has been really important,” she emphasised.

Reflecting on her own experiences of this change, McNaughton said: “Where I work, we work directly with our vision rehabilitation specialists and that has seen a huge improvement in the overall service we provide.”

Wider healthcare professionals

Always aware of the importance of what happens next following the certification or registration of a patient with sight loss, in the late 1990s, McNaughton worked with Focus Birmingham’s Richard Cox, to develop an accredited course at City, University of London for the formal training of Eye Clinic Liaison Officers (ECLOs).

She explained that the role of the ECLO, which supports “any patients with any degree of vision loss and any need for support… and at any point in their sight loss journey,” was developed by the Royal National Institute of Blind People in response to patients saying they did not receive enough information at the end of certification.

The course is still run today by City University and has been key in the rollout of ECLOs, who act as an important link between the hospital and health and social care in the community, she said.

Where McNaughton works in Leicester and Rutland, the department has three ECLOs, “which we would not be without,” she said.

McNaughton explained that, in their role, they “take on all of the burden of the certification and registration process, they have access to all patient records so that whilst somebody is waiting to speak to the consultant, they will take somebody in and have a discussion with them about if there are any particular functional needs and any emotional impact they are experiencing, and they will be able to put them in touch with the local charity, Vista, who provides vision rehabilitation services.”

What happens next?

McNaughton also shared with delegates insight into what happens after a patient receives a sight loss certification or when they are referred into health and social care, highlighting the role of vision rehabilitation specialists (VRS).

She emphasised that as the term has only been officially used for a few months, now formalised training is available through two universities, delegates could know them as rehabilitation workers, rehabilitation officers or rehabilitation officers of visual impairment.

McNaughton explained that when a patient is referred to a VRS, the VRS will conduct a visit and assessment in the home, looking at the patient’s functional needs with a focus on independence and safety.

Sharing her own experiences of the role of the VRS to emphasise the important role they play, McNaughton said that when she is running a low vision clinic at Leicester Royal Infirmary, “they are there.”

“They work with us all of the time,” she said, explaining how she is able to introduce patients to their VRS for support.

Considering what hospital low vision clinics will be like in 30 years from now, McNaughton concluded: “Despite improved detection techniques, sight loss is here to stay. Despite our diagnostic techniques, our numbers are increasing.”