eye care for those with learning disabilities

Guidance on eye care and people with learning disabilities: What you need to know

Recently, GOV.UK updated their guidance on reasonable adjustments for people with a learning disability to include a section on recommendations on their eye care pathway. 

The full document is available to read on gov.uk, however for those who do not wish to read over 7500 words, we have done the hard work and collated together some of the main takeaways. 

And if even this is too long, there’s a one sentence summary right at the end.

Introduction to eye care for people with learning disabilities

  • “There is a legal obligation for eye care services to make reasonable adjustments to ensure that people with learning disabilities can access services in the same way as other people.”
  • Adults with learning disabilities are 10 times more likely to develop serious sight problems and children are 28 times more likely.
  • Not having glasses fitted with the correct prescription is the single biggest cause of avoidable sight loss in the world.
  • The guidance is primarily intended to be of use to family, carers and paid supporters that would help someone they care for to access eye care services. It also aims to help eye care professionals to provide services that are accessible to people with learning disabilities. 
  • They briefly define what “learning disabilities” mean and list example signs that may indicate that someone has a learning disability. 
  • Reasonable adjustments can mean something physical or abstract. For example, installing lifts or providing staff training. Public sector organisations must not be passive in this regard. They must not wait for issues to arise before attempting to tackle them. Measures must be put in place in advance. 
  • The general recommended sight test interval is 2 years for adults and 1 year for children (the document does not specify an age range). 
  • SeeAbility has a national database of optometrists and dispensing opticians and the facilities they have for people with learning disabilities. 
  • Public Health England recommends a full eye examination (as opposed to the normal orthoptic led vision screen) as part of the “school entry health check” for 4-5 year olds with learning disabilities and autism. 

Reasonable Adjustments

  • Those administering eye tests are encouraged to make changes to the tests if the patients are unable to successfully take them. For example: “some people with learning disabilities will not be able to sit near fixed equipment for an examination. Therefore, there is a need for robust portable equipment, including a portable slit lamp and a binocular indirect ophthalmoscope.”
  • Research has shown that health and social care professionals who often work with those with learning disabilities are able to significantly benefit from further awareness training. This not only helps with their interactions with patients, but also encourages them to consider what adjustments need to be made. 
  • A flagging system can be implemented to give staff enough opportunity to provide reasonable adjustments when needed.
  • “Partnerships working between mainstream health services, specialist learning disability teams and family carers or paid supporters of individuals can improve access to healthcare for people with learning disabilities.”
  • It is acknowledged that the price of glasses is a known barrier for those with learning disabilities. Simon Berry, an optometrist for over 20 years and OXSIGHT clinical partner, says: “ I questioned why people were able to have frames for special facial characteristics under the hospital voucher system, but not under GOS (General Ophthalmic Service). This was an obvious inequality that affects people with learning disabilities from conveniently accessing the frames they needed.”

For those of you who skipped to the end, the main takeaway is this, excerpt taken from Article 12.2:

“It is important that the Equality Act is adhered to and that people with learning disabilities are not discriminated against, irrespective of where they are seen.”