Being “eye care aware”. Prompts for the GP Learning Disability Annual Health Check on eye care and vision.

Introduction

SeeAbility is a charity that has helpful information and advice, including in easy read, to support people to get the eye care they need, but also hosts information on local sight testing services for people with learning disabilities and raises awareness of the high risk of sight problems in this patient population. 

Read more about eye care.

Did you know?

• Sight problems are one of the most common health comorbidities for people with learning disabilities.
• People with learning disabilities are 10 times more likely to have a sight problem than other people. At least six in ten people will need glasses.
• The likelihood of a sight problem rises further still among people with severe or profound learning disabilities, and with certain syndromes or neurodevelopmental disorders (eg. Down’s Syndrome, Cerebral Palsy).
• However, people with learning disabilities miss out on eye care. Sight problems – such as needing glasses, cataracts and glaucoma, can be easily overshadowed.

Sally’s story: diagnostic overshadowing led to permanent sight loss

Some years ago Sally started rubbing her eyes and described an ‘itch’ on her head - her way of saying she had a headache. The GP prescribed drops for hayfever and looked into whether Sally had a thyroid or scalp problem. In fact Sally had glaucoma, this was only identified once Sally’s sight loss became more pronounced.

Prompts for the annual health check on eye care and vision

The following are prompts for before, during and after the annual health check that can help direct patients with learning disabilities to the eye care they need.

Pre annual health check: gathering information

Prior to the annual health check there may be an opportunity to gather key information to make the most of the appointment. For vision, this should include as a minimum:

• Any current concerns
• Date of last eye test (SeeAbility recommends an annual test as a minimum for everyone with a learning disability)
• If the person wears glasses and if so what tasks they are needed for
• If the person has a diagnosed eye condition and if so are they seen at hospital eye clinic or under diabetic eye screening i.e. how eye conditions are being monitored

SeeAbility also holds a plain English ‘About me and my eyes form’ which people can fill out with more detail on their eye care needs.

During the Annual Health Check: in person

The meeting with the person is an opportunity to ask and/or review the answers the patient has given to the eye care questions above.

It is also an opportunity to observe how the person is using their vision.

• If they say they use glasses, are they wearing them? 
• Are there any noticeable issues with their visual behaviours, mobility, eye health or eye movements?

After the Annual Health Check: next steps

Further action to support eye care needs in the Health Action Plan might include onward referral to hospital eye services but more likely it is a prompt to have a reasonably adjusted eye test. SeeAbility holds a database of optical practices that have registered to promote their offer to patients with learning disabilities.

• GPs and patients can put in their postcode and search via our database of optometrists.
• In some areas referrals can be made into an ‘Easy Eye Care’ pathway. In the areas where these are commissioned they offer targeted support for people with learning disabilities. 

For more information contact SeeAbility at eyecare@seeability.org.