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Bringing eye care to elderly people at home

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Arif Ladha, BSc (Hons), MCOptom.

Regional Clinical Manager, Healthcall Optical Services, and a member of the Federation of Ophthalmic and Dispensing Opticians

Many elderly people still want to continue to live relatively independent lives and preserve their dignity, but they do not always have access to services that would allow them to do so. One such vital service is eye care.

Many elderly people still want to continue to live relatively independent lives and preserve their dignity, but they do not always have access to services that would allow them to do so. One such vital service is eye care.

Government figures reveal that, although over a million people need domiciliary eye care, 700,000 people are going without such care.

Few could argue with the statement that vision is one of the most important of the five senses. Poor vision can contribute to personal accidents and an increasing sense of isolation, exclusion and frustration. A person's self-confidence can be drastically reduced after a fall.

The NHS is spending millions of pounds treating preventable falls and other vision-related accidents. This applies to elderly people living in care establishments as well as those who live alone in their own homes.

The eye examination should not be seen wholly as a means of providing a pair of spectacles. Ocular conditions such as cataracts, glaucoma and macular degeneration can readily be detected and treatment sought. In addition, the early signs of general medical conditions such as diabetes or hypertension can be highlighted even before the patient develops other symptoms.

The Older Eyes campaign and the Code of Practice
Older Eyes, the new NHS-backed campaign for elderly eye care, was launched on December 7 last year. Run by the Federation of Ophthalmic and Dispensing Opticians (FODO) and the Association of Optometrists (AOP), and supported by the Royal National Institute for the Blind (RNIB), Age Concern and Help the Aged, it is an awareness campaign spearheading the message that domiciliary eye care is essential for anyone who is unable to visit an optician.

Alongside the campaign, the optical profession also launched its Code of Practice for Domiciliary Eyecare. It sets out guidelines for the kind of service people can expect, with procedures for follow-ups and ongoing care. Care homes and carers, as well as individuals in their own homes across the country will, for the first time, have clear guidelines as to what they must demand from optical contractors.

The code will be made available to all such institutions and practitioners, even if they do not belong to FODO or AOP.

The Chairman of the Domiciliary Eyecare Committee, Jayne Rawlinson, said that there had been over two years' work on the code and the intention was to carry on driving it forward, working with primary care trusts to raise awareness, particularly among GPs and practice nurses.

What can you do?
As a nurse you can be a vital link in providing information about the importance of eye care and the means by which it can be obtained for those who need a domiciliary visit. It is also important to open lines of communication between other sectors of the medical profession. The optical profession is working very hard to achieve this, and with your help it can go a long way towards getting there.

How can you make a difference?
It is important to arm yourself with information on domiciliary eye care, or at least the means by which it can be obtained. Below are contact details to help you to do this:

- The launch and full code of practice can be seen at

- The ophthalmic department of your local primary care trust will be able to give you a list of contractors who provide domiciliary eye-care services

- The RNIB can give help and advice for people who have impaired vision. Available at:

- Information about domiciliary eye care within the optical profession can be found at the website for the British College of Optometrists. Available at:

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