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Sight Loss Certification System in UK Causes Confusion, Hinders Access to Benefits

Sight Loss Certification System in UK Causes Confusion, Hinders Access to Benefits

May 25, 2023

A new academic study, conducted by Anglia Ruskin University (ARU) and published in the journal Eye, has reported that individuals with sight loss in the UK face confusion due to a "disjointed" certification and registration system.

This system creates a barrier for those seeking access to support, benefits, and rehabilitation services. The research specifically focused on the experiences of individuals receiving a Certificate of Vision Impairment (CVI) and their subsequent access to welfare, support, or additional healthcare assistance through a Referral of Vision Impairment (RVI).

In the UK, the Certificate of Vision Impairment (CVI) serves as a certification for people who are partially sighted (sight impaired) or blind (severely sight impaired). This certification process is carried out by ophthalmologists, and with the patient's consent, the information is shared with their General Practitioner (GP), local authority, and The Royal College of Ophthalmologists Certifications Office. After receiving the CVI, individuals have the voluntary choice to register with their local authority, enabling them to access various forms of advice and support through a Referral of Vision Impairment (RVI).

In the UK, approximately 2 million people live with vision loss. However, there is significant variation in the registration rates for Referral of Vision Impairment (RVI) across different regions. For instance, in 2016/17, the percentage of people with sight loss in Hampshire who had registered for RVI was 87.9%, while in Rutland, it was only 26%.

To gain insight into the experiences related to care, certification, and registration, researchers conducted interviews with a total of 17 individuals in the UK who had eye diseases. Additionally, optometrists and Eye Clinic Liaison Officers (ECLOs) were also included in the interviews. The participants were asked open-ended questions to gather information about their personal experiences with care, certification, and registration processes.

According to the study, patients expressed confusion regarding the decision-making and procedural aspects of certification and registration. The participants highlighted inconsistencies among certifying individuals, with some being more inclined to certify than others. Additionally, the interviews revealed that patients faced lengthy waiting lists when trying to access support services, and encountered challenges with the capacity of social services provided by local authorities.

The participants also expressed uncertainty about the specific entitlements and accessibility of services associated with certification and registration. Furthermore, the interviews indicated that optometrists were not extensively involved in the certification process.

"Vision loss can be a devastating experience for a patient and there is currently confusion around the process of certification for CVI, which is done through the NHS, and for registering for further support from local authorities through RVI,” said lead author Professor Shahina Pardhan, Director of the Vision and Eye Research Institute at Anglia Ruskin University (ARU).

"It is clear from our research that many feel the process of registration and certification is disjointed, creating a barrier for people with sight loss. It needs to be made simpler and more consistent if people are to receive the support they need."

She further added that enhancing the timeliness, efficiency, and effectiveness of providing information, advice, and guidance on pertinent support services available in local social care and third-sector organizations, along with promoting informed decisions regarding certification and registration by eye health professionals, can significantly benefit patients. These improvements have the potential to enhance patients' well-being and overall quality of life.


Shahina Pardhan et al, Confusion around Certification of Vision Impairment (CVI) and registration processes—are patients falling through the cracks?, Eye (2023). DOI: 10.1038/s41433-023-02520-0