1. Certification and Registration; the practical and social implications
Mrs Stevie Johnson Eye Clinic Impact Team Evidence and Service Impact
Thank you
My name is

2. What is the difference?
Certification?
Registration?

3. Certification and Registration
The Certificate of Vision Impairment (CVI) formally certifies a person as either sight impaired (partially sighted) or severely sight impaired (blind).
The purpose of the CVI is to provide a reliable route for someone with sight loss to formally be brought to the attention of social care.
Registration as blind or partially sighted is provided by Social Service Departments. The purpose of these registers is to help local authorities plan and provide services for people who have sight problems.
Registration is a voluntary choice.
CVI = measurement of acuity and field
timescales

4. Research
The number of people with sight loss is growing, yet there has been a decline in both Certification & Registration numbers
Wanted to research what both patients and health professionals thought of the process, whether people were being certified at the right time, and identify any barriers and delays to the process.
RNIB research – “The Certification and Registration Processes: Stages, barriers and delays”
Method
We interviewed Patients and professionals in three urban areas of England. We interviewed 46 patients who had been certified in the past 12 months and 43 professionals (e.g. 12 consultant ophthalmologists, 4 eye clinic liaison officers, 8 rehabilitation officers) .

5. Key findings
Certification is life changing for patients – people described the help they receive at this time as substantially improving their lives.
There are 5 separate stages in the whole process
Delays to people being offered certification
Criteria not black and white
Clinicians regarding certification as end of process, for patients it provides access to practical and emotional support and more to change and improve their quality of life.
Clinical staff are often unaware of benefits
Stages – involving many different people and potential for barriers and delays at each stage

6. CVI workshops
RNIB, Royal College of Ophthalmologists and Vision 2020 UK ran a series of CVI workshops
14 across England, bringing together staff from eye clinics, social services, local voluntary organisations and patients to look at the processes in that area.
92% of clinical staff say they will change their practice as a result of attending the workshop
New posters about certification in eye clinics

7. Is it possible to get support if you are not eligible to be certified?
Yes!
Referral of Visual Impairment Form (RVI)– can be filled in at the hospital by any eye clinic staff – i.e. Nurse
Low Vision Leaflet (LVL) – available from your High St Optician

8. Story
Mr Hamilton
Mr Hamilton is 82 who lives with his wife of 45 years. She is disabled and he is her main carer. They are very independent individuals and as he says 'as in love as we were on the day we married.'
In 2006 he was diagnosed with wet AMD in his right eye, unfortunately there were no injections at this time and he lost the vision in this eye. He was told he had dry AMD in the other eye and was advised to stop smoking. He was discharged from the hospital into the care of his local optometrist. he managed fine on a daily basis with just one eye. In 2012 he was diagnosed with early wet AMD in his good eye and started to have monthly injections. Although the injections did initially help, over the 2 year period his vision has gradually deteriorated. At first he adapted to the change in his vision, tasks like preparing meals took a bit longer, but 'he just got on with it' as this was his ethos, without realising looking after his wife and the home was putting pressure on his health.
It was at one of his injection appointments that the ophthalmologist asked how he was coping with his vision. When he explained his home circumstances, the ophthalmologist recommend he could be certified as partially sighted. Although he didn’t quite fit the CVI criteria, the ophthalmologist considered the man's social circumstance and certified him early. Even though he is having treatment, the ophthalmologist realised that realistically it is not going to improve his vision enough to be able to drive or prepare food easily.
Mr Hamilton was certified and registered, and was offered support. It has opened up a new world for him, low vision assessment, mobility rehabilitation, increased benefits support, and he and his wife go to the local club for lunch twice a week. Talking to people made him realise how much he has been struggling. He also attends a weekly emotional support session and has local voluntary support to sit with his wife while he has an afternoon off one a week.

9. Thank you Please come and talk to us today www.rnib.org.uk
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