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Anneka Lawson is talking to technician Vicky about her husband. Paul is a police officer, and was recently involved in an accident at work, during which he was hit on the back of the head.

“The doctor says that he’s never going to regain the sight in his left eye,” Anneka tells Vicky. “The damage is just too great and can’t be repaired.”

“Oh, I’m sorry,” replies Vicky. “Is he coping OK? Was his other eye affected?”

“By some kind of miracle, his other eye escaped unscathed,” says Anneka. “His work have put him onto desk duties, but he finds it pretty hard going. In fact, we were thinking of registering him as partially sighted or visually impaired – or whatever the term is nowadays – because someone mentioned that then he’ll be able to claim some benefits. Actually, you might know something about this. Paul’s unsure but I wonder if his reluctance is part of him taking some time to come to terms with it all – he is having counselling though.”

Answer

A certificate of vision impairment (CVI) allows holders to more easily access services and support for individuals who are severely sight impaired – this was previously referred to as blind – or sight impaired, which is sometimes referred to as partially sighted. In Northern Ireland, the certificate goes by the name A655.

However, Paul is not eligible. While his monocular vision – for he only has sight in one eye – means that he considers himself impaired, his good eye largely compensates for the loss of sight in the other, and means he falls outside the criteria for a CVI. Other situations in which a CVI is not issued include someone with very poor vision that can be corrected with glasses or contact lenses, or if the patient is receiving treatment which an ophthalmologist believes is likely to improve their eyesight. For a CVI to be issued, there must be permanent changes to the vision in both eyes.

Nonetheless, Paul may still be able to access help by contacting his local social services department and asking for a care needs assessment, and by getting in touch with local sight loss charities and support groups.

The bigger picture

A CVI triggers a referral for an assessment of the individual in order to provide them with what they need to remain as independent as possible, which may be help with everyday tasks such as cleaning and cooking, transport, rehabilitation, or getting equipment or aids that will be of use around the house. It also provides evidence for claiming concessions, such as help with NHS costs, council tax and public transport costs, and a reduced price television licence, though it is sensible to note that being in possession of a CVI does not, in itself, mean automatic entitlement to benefits.

According to the Royal National Institute of Blind People (RNIB), as of 2014 there were around 350,000 individuals registered as visually impaired in the UK. However, the organisation adds that as of 2015, more that two million people in the UK were living with sight loss severe enough to have impact on their daily lives – for example by stopping them from driving. This number is set to rise due to an ageing population and an increase in medical conditions linked to vision problems such as diabetes and obesity. By 2030, the RNIB estimates there will be over 2.7 million people with sight loss in the UK, and over four million by 2050. 

Risk factors for sight loss include gender (nearly two thirds of those affected are women), learning disabilities, ethnicity (as people from black and minority ethnic communities are at increased risk of some of the leading causes of sight loss) and age: one in five aged 75 years and over have sight loss, and one in two aged 90 years and over.

Extend your learning

• Take a look at the explanatory notes for consultant ophthalmologists when considering issuing a CVI 
• The above guidance uses the terms “Snellen chart” and visual acuity”. Find out what these mean via the RNIB
• Find you local social services and sight loss groups by putting your postcode and “social services” and “local society” at the Sightline Directory.