1. Wirral Low Vision Service Gillian Rudduck Wirral University Teaching Hospital Helen Corcoran Wirral Vision Support Service

2. Aims of Paed LVA service n To improve level of ownership and use of LVA n reduce dependency on enlargement n work in an atmosphere of co- management n monitor usage of LVA n review usage and make adjustments

3. Referral Route n Protocol agreed at a multidisciplinary level n Referral may be requested by –teacher/support worker –parent –GP –ophthalmologist n Referred to vision support service rehabilitation officer

4. n Consent for cross referral –parent –GP –ophthalmologist

5. Preliminary assessment by rehab –reason for referral –current LVA ownership –current LVA usage –distance vision tasks –classroom assessment ergonomics environment –near vision tasks –lighting –desired outcome

6. Multidisciplinary assessment n Child n parent n rehabilitation officer n teacher for visually impaired

7. Paediatric Low Vision Routine n History and Symptoms n Visual Acuity n Near Acuity n Refraction, n Colour vision n Visual fields n Selection of aid

8. n Target setting- agreed n Arrangement for follow up/training n Re-referral n Report to parents, education, healthcare etc..

9. Post clinic follow up n Training with Rehabilitation Officer –tracking, spotting –number games –blackboard,whiteboard –in class –real world –mobility n Reassessment of use n Re-referral as necessary

10. Service developments n User group n user satisfaction survey- parents carers & children n Service redesign

11. n Multi-disciplinary,multi-agency approach n needs based n not dependent on registration n locally designed Recommended standards for low vision

12. Acknowledgements n Vision Support Service, Wirral n Local Consultant ophthalmologists n Colleagues in optometry department n Wirral paediatric eyecare group n Patients and their families

13. Thankyou