Provision of Appropriate Eye Care Services for Adults with Learning Disabilities: the Experience of a Specialist Multi-Professional Visual Assessment Clinic in Northern Ireland

Introduction: Adults with learning disabilities find it difficult to access conventional eye care services. The result is that refractive errors remain uncorrected, treatable pathology goes undetected and visual acuities are suboptimal. Impaired vision limits independence and impacts significantly on quality of life. Methodology: The demographic and visual characteristics of 95 adults with learning disabilities attending a specialist multi-professional visual assessment clinic within a day centre in Belfast were examined and issues relating to co-operation, access and communication addressed. Results: Of the 95 patients assessed, 51(53.7%) were male and the mean age was 38.13 ± 10.71 years (range: 19–65 years). In 43.2% (n = 41) of cases, there had been no previous visual assessment. Only 30.6% of those requiring spectacles had an adequate correction. A total of 25.3% (n = 24) could be classified as visually impaired. Onward referral for treatable ocular pathology was recommended in 5.3% (n = 5) of patients and 11.6% (n = 11) benefited from assessment by a rehabilitation worker. Experience suggests that with the use of appropriate preparatory material, 86.9% can undertake a complete eye examination. The results of the assessment need to be made available in an easy-to-understand format to the individual and to those involved in their care, so that recommendations can be implemented. Conclusion: Key elements to a successful eye examination with adults who have learning disabilities are utilising a multi-professional approach, preparing patients beforehand, carrying out assessments in a familiar environment and ensuring the outcomes are communicated effectively.