Sight Loss Pathway

An eye condition could be noticed by a GP, optometrist, or ophthalmic nurse at a routine appointment, or by yourself through changes in your vision. If you notice sudden changes in your vision, you might attend A+E. You may need to be referred on to ophthalmology for further investigation, diagnosis, and possible treatment.

If you are referred to ophthalmology, there will be a period of uncertainty. Depending on the area you live in, wait times for ophthalmology appointments will vary. Whilst you are waiting, you could ask to speak with an Eye Clinic Liaison Officer (ECLO) and they can support you with any concerns of your upcoming diagnosis and refer you to external organisations for further support.

Having an eye condition diagnosed can be one of the most difficult parts of the pathway. At this stage it is important you feel supported and have all the relevant information to help you prepare for the change in your sight. At this point you should be offered the opportunity to see an ECLO. They work closely with medical and nursing staff in eye clinics, and the sensory teams in social services, and offer emotional and practical support to you and your family. Your ECLO can support you in understanding your eye condition and prepare you for any treatment offered by your Ophthalmologist. They can also help you access psychological support e.g. counselling services. In some hospitals, the ECLO may be part time. You can contact Vision Support directly for help and support at this point. We can always refer you back to the ECLO if you need more help from them.

Once you’ve had your diagnosis you may have an assessment for a Certificate of Visual Impairment (CVI). As the patient you may have to be proactive in asking about the possibility of becoming certified as this is not always an automatic process.

An Ophthalmologist will use a combination of both your visual acuity (a measurement of how well you can see detail) and your field of vision (the portion of space in which objects are visible at the same moment during a steady fixed gaze in one direction) to judge whether you are eligible to be certified, and at which level.  Read more here.

Once the CVI is signed, a copy should be sent to yourself and your local social services team. The CVI can be a gateway to vital services and support however, if you are still undergoing treatment, you may not receive a CVI immediately. You could, however, still be entitled to those vital services and support and eligible for some benefits.

After receiving a copy of your certificate, your local social services team should contact you to ask if you wish to be included on the register of blind and partially sighted people. If you say “yes” then you become registered.

Social services should contact you to discuss carrying out a needs assessment. The aim of this assessment is for social services to find out what help and advice you need to remain independent. This could include help with everyday tasks such as cleaning and cooking, keeping in touch with friends and family, or with transport and getting out and about.

Both eyes must be affected to be eligible for a CVI.

Your certification status will be either Severely Sight Impaired (SSI) or Sight Impaired (SI).

CVIs can only be signed off by an Ophthalmologist (however, Optometrists in Wales can issue CVI’s for people who have Dry Age-Related Macular Degeneration in both eyes as a standalone condition).

If you are not already under the care of the hospital or eye clinic and would like an assessment to find out if you’re eligible for a CVI, your optician or GP can refer you to ophthalmology.

You don’t have to have a CVI to receive support with your vision from social services/sensory team.

It is important to remember that your registration does not follow you so if you move to a new area with a new council, you will need to register with that council using your CVI. Therefore, it is important to keep the copy of your CVI as proof of certification.

Each council has a team of people that are specially trained to support people with vision impairment/ sensory loss. You can access this service through contacting your local Adult Social Care Service/Single Point of Access (SPoA). If you haven’t heard of this, you can call SPoA and ask to be put in touch with the sensory team/visual impairment team.

A Vision Rehabilitation Specialist (VRS), formally known as Rehabilitation Officer for the Visually Impaired (ROVI), can support you in and outside of your home with communication skills, using technology, orientation and long cane mobility training, independent living skills training, understanding eye conditions and prognosis, and advice and training on low vision aids.

The terminology does differ from county to county, and we know that the amount of information combined with your diagnosis can be overwhelming, but it’s important to know that they are there and ready to help support you to remain independent.

It is important to know that you do not need to have a CVI to access Vision Support services and you can contact us at any point during your pathway.

Optometrists typically work in opticians on your local high street, they are trained to examine the eyes to detect defects in vision, signs of injury, ocular diseases or abnormality and problems with general health, such as high blood pressure or diabetes. They may assess vision through an eye test and offer clinical advice, prescribe spectacles or contact lenses and refer patients for further treatment, when necessary. An Optician takes the prescription from an Optometrist or Ophthalmologist and provides support to select the correct eye wear and lenses and ensure that they fit well to optimise the effectiveness to support vision.

Ophthalmologists are doctors who care for patients with eye conditions. They diagnose, treat and prevent disorders of the eyes and visual system, using medical and surgical skills.