Support for infants and young people with sight loss: a qualitative study of sight impairment certification and referral to education and social care services

Boyce, Tammy; Dahlmann‐Noor, Annegret; Bowman, Richard; Keil, Sue

doi:10.1136/bmjopen-2015-009622

Cited by 7 publications

(22 citation statements)

References 22 publications

(25 reference statements)

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“…Certification in children is of particular importance as the practical support offered as a result can help support development in motor, language, cognitive and social skills, with early intervention being essential for better outcomes [14]. Children who have a CVI completed are not necessarily registered with their local authority.…”

Section: Rates In Childrenmentioning

confidence: 99%

Recent trends in vision impairment certifications in England and Wales

Rahman

Zekite

Bunce

et al. 2020

Eye

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Background The Certificate of Visual Impairment (CVI) provides essential data for preventable sight loss indicators as part of the Public Health Outcomes Framework (PHOF) published annually by the Department of Health. Trends in CVI certification rates can provide information on the effectiveness of current services and treatments and may be used to guide allocation of resources, and is the only such indicator within ophthalmology. This study aimed to compare recent trends in new vision impairment certifications in 2017/18 against prior baseline data in England and document trends in new certifications in Wales. Methods PHOF data from 2010/11 and 2017/18 were examined with respect to preventable sight loss indicators: age-related macular degeneration (AMD) (Indicator E12a), glaucoma (Indicator E12b), diabetic eye disease (Indicator E12c) as well as the total numbers of certifications (Indicator E12d). Results In 2017/18, the rate of new CVI certifications was 41 per 100,000 population which has reduced from 43/100,000 in 2010/11 in England. Certifications for AMD reduced from 132/100,000 in 2010/11 to 107/100,000 in 2017-18. Certifications for glaucoma have remained stable at 13/100,000 in 2017/8. Certifications for diabetic eye disease have declined from 4/100,000 in 2010/11 to 3/ 100,000 in 2017/18. The number of vision impaired individuals that each Clinical Commissioning Group (CCG) has to support varies from 8 to 82 per 100,000 population. Conclusions There has been a significant decrease in the rate of all CVI certifications particularly from AMD and diabetic retinopathy. However, maintaining this will require changes in the way care is delivered as the elderly population, which is at greatest risk of preventable sight loss, is projected to increase by 50% over the next 20 years. Inherited retinal diseases are now the leading cause of sight loss in the working age population. CVI data demonstrate the need for CCGs to tailor their investment in ophthalmic services to the needs of their specific patient populations. It is important that all ophthalmologists continue to provide accurate CVI data in order to help support the future equitable allocation of adequate resources to reduce avoidable vision loss.

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Section: Rates In Childrenmentioning

confidence: 99%

Recent trends in vision impairment certifications in England and Wales

Rahman

Zekite

Bunce

et al. 2020

Eye

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“…Children can be certified, registered and offered a social care assessment; however, their primary need is for early developmental support from specialist teachers and the child development team, and referrals to these services should be made as soon as impairment is identified. Additional help that may be provided later following a social care assessment may be valued by parents 6. Certification and registration do not function as a direct route to early educational and developmental support.…”

Section: The Populationmentioning

confidence: 99%

“…Referral to the VI service should be made as soon as possible after a VI has been identified and should not depend on certification status or process. Delays in referral can have a significant impact on the parent as well as the child 6. A key resource for use by parents with QTVIs is the Developmental Journal for Babies and Children with VI 15…”

Section: How Children and Young People Are Supportedmentioning

confidence: 99%

Management of children and young people with vision impairment: diagnosis, developmental challenges and outcomes

2016

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Vision impairment (VI) has a significant impact on an individual's ability to engage with everyday tasks. Severe early-onset VI presents different challenges to adult onset visual loss since reduced visual input presents a major obstacle to the acquisition and development of fundamental developmental skills in early and later childhood. Early referral of the child with reduced vision is vital to ensure accurate diagnosis and prompt treatment of any modifiable aspects of the condition. Guidance to ensure optimisation of developmental opportunity through adaptation of play and care is vital from the earliest stages. Cognitive and social challenges occur throughout education and need to be understood and addressed through skilled support. Multiagency input, particularly from health and education, is vital to minimise the risk of adverse outcomes and promote successful transition to independent adulthood. VI may also arise in a variety of neurological disorders, and diagnosis and assessment to ensure appropriate adaptations are made is also crucial for this group of children. This review provides the paediatrician with information on diagnosis, assessment, long-term support needs and outcomes.

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“…Determining certification status in children with developmental delay presents additional challenges which may impact on time to certification in children. 4 Certification takes place within Eye clinics and there is evidence of poor uptake of hospital eye care for children with significant visual needs. 10 …”

Section: Discussionmentioning

confidence: 99%

“…Registration may bring financial and practical benefits to the patients and there is evidence that in children early interventions can decrease risks of delayed development in motor, cognitive, language and social domains. 4 In England and Wales, a copy of the CVI is sent to the Certifications Office for epidemiological analysis. The Certifications Office, based at Moorfields Eye Hospital, London operates under the auspices of the Royal College of Ophthalmologists and provides data to Public Health England and the Welsh Government.…”

Section: Introductionmentioning

confidence: 99%

Is there evidence that the yearly numbers of children newly certified with sight impairment in England and Wales has increased between 1999/2000 and 2014/2015? A cross-sectional study

et al. 2017

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ObjectivesTo use routine data capture from hospitals in England and Wales to identify whether there has been an increase in the annual numbers of children newly certified sight impaired in England and Wales between 1999/2000 and 2014/2015 and to examine causes of certifiable sight impairment in children certified in 2014/2015.DesignA cross-sectional study including an analysis of all certificates of vision impairment completed in hospitals in England and Wales each year between 2007/2008 and 2014/2015 and all certificates completed in hospitals in England and Wales in 1999/2000.ParticipantsCertificates for all individuals aged 16 years or less at the time of certification in England and Wales for each financial year between 1 April 2007 and the 31 March 2015 and for individuals aged 15 years or less for the year ending 31 March 2000. We obtained information on the main cause of certifiable sight loss for all children certified in 2014/2015. We estimated crude and sex specific incidence estimates with 95% confidence intervals computed by Byars method.ResultsIn 1999/2000, the estimated incidence (95 % CI) of certification was 8.2 (7.7 to 8.8) per 1 00 000. In 2007/2008, the estimated incidence was statistically significantly higher at 10.1 (9.5 to 10.7). Since then a trend of increasing incidence with time has been observed until 2014/2015 when an estimated incidence of 13.3 (12.6 to 14.0) was observed. Hereditary retinal dystrophies, cerebral visual impairment and nystagmus were the most common single causes of certifiable sight impairment in children in 2014/2015.ConclusionOur findings show that in England and Wales there has been an increase in the number of children newly certified sight impaired by consultant ophthalmologists since 1999/2000. This mirrors our previous findings based on data originating within social service departments.

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Support for infants and young people with sight loss: a qualitative study of sight impairment certification and referral to education and social care services

Cited by 7 publications

References 22 publications

Recent trends in vision impairment certifications in England and Wales

Recent trends in vision impairment certifications in England and Wales

Management of children and young people with vision impairment: diagnosis, developmental challenges and outcomes

Is there evidence that the yearly numbers of children newly certified with sight impairment in England and Wales has increased between 1999/2000 and 2014/2015? A cross-sectional study

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