In a paper we have recently published we show that in a large cohort epidemiological study, older people who self-rate their eyesight as ‘poor’ or ‘fair’ were twice as likely to be inactive (undertaking moderate physical activity less than once a week) than people rating their eyesight as ‘excellent’. The data presents an association rather than cause and effect. However, there is the potential for lack of physical activity to lead to an increased likelihood of health problems that can cause poor eyesight, such as diabetes. Equally, it can be more difficult for people with poor vision to exercise and be active. In another recent study we showed that ‘physical activity and / or sport’ was the third most challenging activity of daily living for people with the eye condition Retinitis Pigmentosa. Finding ways to help people with poor vision exercise safely therefore has the potential to be extremely valuable. For those with poor vision, I would highly recommend British Blind Sport, for information on a range of different sports. The RNIB website also has a good overview of available resources. One organisation particularly close to my heart is parkrun, who organise free weekly 5k runs around the country (and the world). They are undertaking a project to provide guide runners to people with visual impairment to enable them to take part. I would be more than happy to volunteer as a guide for anyone in the Cambridge area, bearing in mind that as I don’t run very fast I would be much more suited to guiding a beginner!
Prof Peter Allen and myself are currently recruiting a postdoctoral research fellow to work on an exciting project relating to vision and sport. We are looking for someone with a PhD in either vision or sport related areas, and further details of the position and how to apply are on the Anglia Ruskin University website. As background information, some of our preliminary work in this area might be of interest.
A couple of weeks ago I took part in the 10th annual Rasch User conference in my childhood stomping ground of Durham. It was an extremely interesting day and even involved a fantastic interval-scale cake! My presentation was on the use of Rasch analysis in understanding rehabilitation needs in low vision, the slides for which are now available.
The Royal College of Ophthalmologists has suggested that increasing demand on hospital eye care services from long term conditions is putting peoples’ sight at risk. The College of Optometrists has noted that one way to try to reduce pressure on services is provision of community based services. In an interview about the situation local to Cambridge, I’ve tried to highlight how some of our current local community schemes (direct cataract referral, glaucoma referral refinement, monitoring of ocular hypertensives and minor eye conditions pathway) are helping to ease the pressure, whilst we can still do more in terms of community based low vision service provision.
Visual loss caused by Retinitis Pigmentosa (RP) obviously causes difficulty with practical activities in daily life, which we reported in a recent study (Latham et al., IOVS, 2015). However, loss of vision can also lead to significant challenges to emotional health, and we have just published a subsequent paper (Latham et al., PLOS ONE, 2015) to examine what aspects cause greatest difficulty for people with RP.
166 people with RP completed a questionnaire about their emotional health, and the two most difficult items were found to relate to communicating visual loss to other people (specifically, ‘dealing with misunderstandings from others because of your visual impairment’ and ‘explaining to others what you can and cannot see’). We suggest that partly this is because explaining vision loss is very difficult, but is also made more difficult if other people do not have a good understanding of vision loss – perhaps thinking that ‘blind’ means unable to see anything at all, or that only central vision is affected.
Other difficult tasks involved dealing with feelings of frustration and anger, stress and anxiety. There are programs available based on problem-solving approaches that address these topics, which have been shown to be helpful in some groups of older adults with macular degeneration, but we are not aware of any programs of this nature that have specifically targeted people with RP.
Another difficult task was ‘performing daily activities without suffering discomfort in the eyes, such as eyestrain’. Possibly this finding highlights the importance of regular eye examinations or low vision assessments to ensure that spectacles, tints, lighting and low vision aids provide as much support to residual vision as possible to allow tasks to be done as comfortably as possible.
A further key finding was that some groups expressed greater difficulty as a whole with the emotional health tasks, and this included people who use mobility aids, and women. We speculate in the paper as to why this might be, but it may be useful as an indication of who might be in greatest need of help with the emotional consequences of RP. We also found that the difficulty expressed did not depend on how long people has been visually impaired or the severity of visual loss, suggesting that people with RP might need help with the emotional consequences of visual loss at any point.
Many members of RP Fighting Blindness contributed to this research by answering the questionnaire, and we would like to thank you all for your time and enthusiasm for the project. We hope this study is useful and of interest to people with RP, and to those involved in supporting, caring and providing rehabilitation for people with RP.
As a summary of the recent work we’ve done on how an acuity of 6/12 relates to the ability to read a number plate at 20m – both standards for driving in the UK – have a peek at the article in Optometry in Practice this month. The answer is ‘quite well, but not perfectly’, which has implications for optometrists advising patients on their fitness to drive, and for drivers trying to work out if their vision is good enough to meet the standards. With the latter, the first port of call should definitely be to book an eye examination!
The College of Optometrists were happy for this paper to be made available via Anglia Ruskin University’s institutional repository, so can also be viewed here.
A very warm welcome to all the students who are about to start or return to Anglia Ruskin in the next week or so. I’m looking forward to meeting the new first year optometry and dispensing optics students, and to helping the new final year optometrists get back up to speed in the clinic next week…..
Meanwhile, a big welcome to new postgraduate student Jane Macnaughton, who has just started a project with me funded by the College of Optometrists and based at Vista to understand the ‘Rehabilitation needs and adjustment to visual loss of visually impaired people over time’.
Many years ago, an already successful independent optometrist took a punt on employing a gawky 21 year old who didn’t interview very well as a new pre-reg. I learnt a huge amount about how to practise optometry and about myself that year. And while I might have fled back into academia at the first opportunity, thanks to what I learnt then I’m proud to still be working in independent optometric practice at least some of the time. I’m also very proud to find that my old boss, Kevin Thompson, has been announced as the new Chairman of the Association of Optometrists – he’s going to be great!
Already a qualified optometrist? It might be time to think about College Higher Qualifications. Current poster girl looks a bit familiar… I’m wondering whether to do Higher Cert in low vision or Professional Cert in glaucoma next. Whichever it is I need to finish my marking first though!