Richard Wormald: My name is Richard Wormald.
I'm an ophthalmologist and I'm a consultant at Moorfields Eye Hospital, where I've been
since 1994.
Mr Radford?
The certification of vision impairment is making an official statement about patients'
level of vision.
It's an extremely important process for patients who are having difficulty with their vision,
because it opens the door to a wide range of services and support.
But most importantly, really, they're about letting the local Social Services know that
you have a problem with your sight, and then you can be contacted and offered a range of
options.
The services and benefits that are available depend, to some extent, on whether you're
certified as vision impaired or severe vision impaired.
We don't register you here.
We fill in a form, which is a certificate, to say you're entitled to be registered with
a local...
Nick Radford: My name is Nick Radford.
I have retinitis pigmentosa.
It's a genetic disorder, and over the past six months or so, I've noticed quite a bit
of deterioration.
The main thing that getting certified helped me to realise was just exactly what's on offer.
As I've had this condition for a long time, I feel like I cope very well, but that doesn't
mean that there aren't other ways of doing something or things out there that can help.
Richard Wormald: So, if you're willing to go ahead, shall we
consider filling in the form now?
Nick Radford: Yeah, yeah, definitely.
Richard Wormald: If that sounds okay.
Ophthalmologists vary in their attitudes towards the process of offering certification, and
it's, to some, an admission of defeat.
You know, your treatment has not been effective in preventing someone losing their eyesight
or preventing their eyesight deteriorating.
To others, it's only something that you do when there's nothing else that can be done
or offered, and sometimes, patients and surgeons together get into a kind of collusive relationship,
where they're trying to avoid actually getting and admitting the fact that the vision's got
to a point where they're entitled to all this additional support.
Nick Radford: When I was first informed that I could be
certified as visually impaired, I was in my mid-teens.
My initial reaction was very negative.
It was that psychological barrier of thinking, that's me admitting defeat.
Richard Wormald: I think in this case, because the sight has
got so poor, you're entitled to be certified as severely vision impaired.
That doesn't mean you're completely blind - far from it - but according to the criteria,
your sight is poor enough to entitle you to the maximum level of benefits.
The best way to introduce the idea of certification of sight loss to a patient is to emphasise
that it is not the end of the road.
It doesn't mean we can't do anything else to help.
In fact, it means there's a lot more that we can do to help, and this is the process
that enables it.
It certainly helps if you've mentioned it before, so it doesn't suddenly come out of
the blue, and very important now, as we've learnt over the last few years, the availability
of an eye clinic liaison officer who can pick up that patient after you've had that conversation
and follow through with support.
Nick Radford: The best thing, for me, going through this
process and getting myself certified and registered, is it feels like I am, rather than admitting
defeat, it feels like I'm, you know, planning ahead and being proactive and, in a way, not
letting my condition get the better of me.
It's opened up these much easier, much healthier opportunities and pathways to deal with different
things, so that in the future, I know that there's support and that I can cope.
Richard Wormald: Sometimes a patient will ask about certification,
and I must say, I'm rather impressed when that happens.
It's my view that patients need to be empowered.
They need more information about what is available and what they're entitled to, and I think
we should have information in our clinics about sight loss certification and encourage
people to ask about it if they're having any difficulty.
It limits your ability to do certain tasks, presumably.
Another barrier for colleagues to actually get on and offer certification to patients
is the perception that it's a tiresome, bureaucratic task.
That's not true.
But one thing that clearly needs to happen, and we've been trying to make happen for a
while and will certainly happen soon, is we'll do this as an electronic online process, where
it can be done quickly on a computer screen with the patient present, so you can fill
the form up together, press the button and it sends it straight to Social Services in
an instant.