How to ensure sight loss is never forgotten

Post date: 
Tuesday, 14 April 2015

Linda Cruickshank and Suzy England share ten essential tips that all occupational therapists need to know when working with people with sight loss.

With the number of blind and partially sighted people expected to rise to almost four million by 2050, it is important that anyone working as an occupational therapist is able to spot the signs of a client who may be experiencing sight loss at the earliest opportunity.
 
Although sight loss can occur at any age, it is more prevalent in older people with the majority of people registered blind and partially sighted, aged 75 or over. The following tips will help ensure that the issue of sight loss is not forgotten when assessing clients.

1. The area of sight loss is huge. Where can I find more information on it?

It is important to improve your understanding of how sight loss affects function and how this can affect independence. There is plenty of information on a number of websites but you can start with RNIB, Thomas Pocklington Trust and British Association of Occupational Therapists and College of Occupational Therapists  

2. Don’t be afraid to ask your client about sight loss…

Ask questions about sight in all of your assessments. Detection of sight loss is vital in finding early treatment that may save sight and introducing steps to make the most of his or her sight.
 

3. And include these five essential questions  

  • Do you have difficulty reading small print?
  • Do you have difficulty recognising faces?
  • Do you miss or overfill cups when pouring liquid?
  • Do you have difficulty judging steps/stairs/kerbs or tripping/falling?
  • Does anyone in your family have glaucoma?  
If the person has communication difficulties these questions will need to be included as part of the overall observational assessment. Carers may be needed to answer questions when communication is difficult. It is possible for a carer to be unaware of any sight loss or changes to vision and unable or unsure of answering your questions. Therefore, an occupational therapist should set up a few tasks such as filling a cup, reading or walking up and down some steps to observe how the client is using their sight.

4. Time for an eye test?

Promote regular eye health checks with a local optometrist or domiciliary visit for people who are unable to leave their home.

5. Document everything 

Record information and recommendations for support in correspondence such as care plans or electronic records. 

6. Uncover hidden sight loss 

Extra care and attention needs to be given to "hidden" sight loss for people who may have difficulty communicating or understanding that they have lost their sight. This includes people with dementia, a learning disability or stroke.

7. Let there be light 

Ensure there is sufficient lighting to support vision and colour/contrast within the environment. Many people with sight loss need and benefit from enhanced lighting. It also means they can make the most of their sight.

8. C is for...

There are three important rules relating to clients who wear glasses. So don’t forget the three C’s
  • clean - are the glasses clean or does the person repeatedly clean them? 
  • current - is the prescription up to date?
  • correct - are they wearing the correct glasses for the task they are undertaking?

9. It’s good to share

Share information about the person’s sight with colleagues, other professional services and families, so they can take action on sight loss too.

10. Here to help 

Many professionals leave it late to refer a person to vision rehabilitation/specialist services. As frontline assessors occupational therapists are ideally placed to identify any difficulties with sight and refer on to appropriate services. 
 
  • Linda Cruickshank is a Vision Support Officer, RNIB and Suzy England is an Occupational Therapy and Sight Loss Consultant at Thomas Pocklington Trust.

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