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Eye health - Living with low vision

NHS Choices Feature

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Nearly 2 million people in the UK are affected by low vision, but you can maximise poor eyesight if it's dealt with properly.

Sonal Rughani is an optometrist and senior adviser at the RNIB (Royal National Institute of Blind People). She explains what low vision is, and how it can be managed properly.

What is low vision?

Low vision is when a person's sight can't necessarily be corrected with glasses or contact lenses.

Low vision doesn't develop just because of old age. Your vision can get worse as a result of cataracts, age-related macular degeneration or diabetic retinopathy.

According to the RNIB, around 2 million people have significant sight loss in the UK. This includes an estimated 80,000 people of working age and 25,000 children.

Very few people have complete 'black' blindness, so any residual vision (remaining eyesight) needs to be maximised. People come to a clinic hoping that a pair of glasses will fix their vision, but they often can't. Low vision is treated by maximising the patient's eyesight beyond what glasses or contact lenses can achieve, and managing a patient's expectations.

When should you visit the optician?

Any decline in your sight should be checked by an optician. Signs that you need to seek help include:

  • Colours look a bit washed out.
  • You're finding it difficult to judge the depth of a step.
  • Straight lines look wobbly.
  • You find it hard to read.
  • You're struggling to see signs when you're driving.

Most importantly, do not wait for these signs to appear. They're not just a part of getting older, they're telling you that something is wrong. Certain eye conditions, such as dry age-related macular degeneration, can't be prevented. But apart from these, no one needs to suffer from worsening vision.

Everyone should visit the optician every two years. Many people are entitled to free eye tests, so find out if you're eligible for free eye care.

What kinds of NHS support are available?

The eye care journey begins with a visit to the optometrist. If a problem is detected, you'll be referred to the hospital to see an ophthalmologist (eye doctor). Your GP will be involved throughout the process, and will provide additional medical information.

If the doctor finds that your vision can't be improved by medical or surgical treatment, you might be referred to a low-vision clinic where you can start registering as partially sighted or blind. At a low-vision clinic, an optometrist may advise you about lighting and low vision aids.

Being told you can't see (and that glasses or surgery can't improve your vision) can be a shock. It's very difficult to get used to that level of sight loss. Getting support after diagnosis is an important part of the rehabilitation process.

What is a low-vision aid?

A low-vision aid can be one of the following:

  • An optical low-vision aid, such as magnifiers (PDF, 1.73MB). These include illuminated magnifiers, hand-held magnifiers or flat magnifiers. Aids for viewing faraway objects include monoculars and binoculars.
  • Non-optical low-vision aids include everything from an anglepoise lamp, to bold-print books or liquid level indicators that beep to prevent you burning yourself when using hot water.

During a low-vision assessment, an optometrist will try different magnifiers to see what works, and tailor it to your individual needs. For example, they will work out if you need help for sewing, reading music, doing a crossword or reading the headlines in a newspaper.

How do I become registered as partially sighted? And what are the benefits of this?

If your vision can't be improved beyond a certain point, you can register as partially sighted or blind. The doctor will fill out a Certificate for Visual Impairment (CVI), which documents your eye condition, the extent of your vision, and whether you have problems with visual field loss. The form will also state whether you're living alone and whether you need additional support.

After you and your doctor sign the form, copies of it will be sent to you, your GP, social services and the National Census. One copy will also be kept in your medical records. Social services can then register you before getting in touch to offer support.

What can the RNIB do?

The RNIB can support you in many different ways. These include offering advice about your eye condition, advice about daily living skills, and accessing information about welfare rights and benefits. We also give information about leisure activities or holidays, befriending services, emotional support services, as well as advice on low-vision aids and where you can get them.

The helpline number is 0303 123 9999. If you need to speak to someone in a language other than English, there are 80 languages available.

Video: cataract animation

This animation explains what cataracts are, and how they affect the eye.

Medical Review: March 05, 2012

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