Factsheets Eye Care for People with Learning Disabilities

Introduction

People with Learning Disabilities are particularly prone to having eye problems.

UK Government policy says that no one should be offered less favourable treatment because he or she has a disability.  However, people with learning disabilities are still often denied health care, including access to eye care services.

We all need to promote the eye care needs of adults with learning disabilities. 

Eye care services can radically improve peoples’ lives, yet ignorance of the benefits of eye care is common. 

If not treated, even a small deterioration in vision can cause significant difficulties for people with learning disabilities. 

Many causes of blindness are preventable if identified early and treated with medication or surgery.

People with learning disabilities should be encouraged to visit Optometrists (Opticians) at least every two years.  In some cases people may have their eyes examined by a visiting (domiciliary) optometrist in their own home or day service.  Some people might visit special optometry clinics set up in eye hospitals. 

Research information

• About 30% of people with learning disabilities have a significant impairment of sight.  There is a high rate of under-detection of sensory impairments, most of which can be treated” (NHS Executive, 1998, Signposts for Success). 
• A recent report states that over just over half of all people with learning disabilities (52%) had received an eye test in the last twelve months (People with learning disabilities in England, CeDR Research Report 2008).
• This represents an improvement since 1998 when it was reported that 53% had not received an eye test in the previous two years (‘The NHS - health for all? People with learning disabilities and health care’, published by Mencap, London, June 1998).

Issues reported to Look Up

We are often told about:

• people in their 40s, 50s and 60s (or even older) who have never had an eye test 
• people who were born blind or with low vision but whose sight loss was never identified
• people who need glasses   
• people whose sight has been damaged or lost unnecessarily
• people denied high quality sight tests
• people who have been denied eye surgery
• Services failing to identify sight in people with learning disabilities
• Services failing to record important information about sight and hearing in Health Action Plans or Person Centred Plans
• Services that fail to provide staff with appropriate training

Unidentified eye problems

It is a scandal that so many people have unidentified eye problems which may be causing pain or preventing independence.

People's quality of life can be greatly improved when their sight problems have been identified and they receive appropriate help to take more control over their lives.        

To help identify visual impairment, we have produced the factsheet, Recognising eye problems in people with Learning Disabilities.

Some people have no outward signs of visual impairment, which is why regular eye tests are so important.

Eye tests and eye examinations

Optometrists/opticians do not just establish if people need glasses.  They provide an “eye health check” to discover if people have infections or sight-threatening conditions.

You don't have to be able to talk or read in order to have your sight tested.  There are tests developed for adults with limited communication. 

Where people cannot fully or partly participate, there are sight tests that record an individual's reflexes and involuntary movements.  Our series of factsheet, The need for an Eye Examination explains how to prepare a person for a sight test.  

Our Telling the Optometrist about me form will help to provide information to the Optometrist before the examination, and the Feedback from the Optometrist about my test form will provide information back to the person having their eyes tested.

Glasses

Newly prescribed glasses may change the way some people see their world.  Staff and carers often assume that glasses will automatically be rejected by some people, but there are successful ways of helping people to get used to them.  

Eye surgery

Many adults with learning disabilities, including those with multiple disabilities, have had successful eye operations (for example to remove cataracts).  Sometimes supporters may decide that surgery would be too traumatic, but they should weigh that opinion against how the person might cope with being blind for the rest of their life.  More information can be found in the factsheet Eye Surgery for people with Learning Disabilities  Advice and information about  Consent for Medical Treatment.

Support for people who have been registered as blind, severely sight impaired or partially sighted   

Many blind and partially sighted people with learning disabilities are isolated, anxious or afraid.  The effects of their visual impairment may not be understood because they have not received the support they so desperately need.  This may result in their quality of life being poor.  Some people may have not learned skills because their sight problems have not been acknowledged, whilst others may develop behaviours that others may not understand or describe as being challenging.

People who lose their sight often experience great difficulties trying to adjust to their new lives.  It is important that people are assessed by rehabilitation officers and specialist workers for visually impaired people as soon as possible. These staff are usually employed by social services/social work departments or a local voluntary society for blind and partially sighted people.

People with learning disabilities are at risk of depression or developing behaviour that challenges, if they are not offered help when their sight deteriorates. Sympathetic and timely support helps people retain their independence and take control over their lives.  

June 2009 

Related Information:

Preparing for an Eye Examination

The Eye Examination Explained

After the Eye Examination

Who is Eligible for Help with the Costs of an Eye Examination?

Watch the You and Eye Film

Eye Surgery for people with Learning Disabilities

Eye Poking and Touching in People with Learning Disabilities

Eye Poking and Touching - Strategies for Supporting People

Recognising Eye Problems in People with Learning Disabilities 1

Recognising Eye Problems in People with Learning Disabilities 2 

Taking Action on Eye Problems

Telling the Optometrist about me form 

Feedback from the Optometrist about my test form