‘It’s that time of the year again, my annual appointment at the eye clinic, always unsure why I am attending, there is nothing the consultants can do for me as a patient living with retinitis pigmentosa. Becoming more and more anxious, numerous conversations going on in my mind as, I know all they can really say is that my vision has got worse or stayed the same, there is no cure or treatment available to me. It therefore feels like a pointless exercise to repeat the obvious.’
Arrival
‘As I reach the eye clinic, hands sweating, I approach the reception desk, already the lighting in the room is patchy, darker in the waiting area then lighter at the reception desk. I take a moment for my eyes to adjust. There are two people, neither of them really acknowledge that I am standing there, a muffled ‘what is your name?’ is heard, but I’m not quite sure if it is directed at me. It is very difficult to focus with the bright light overhead. I’m signed in, and then told to ‘sit over there’ and I am now thinking ‘where is over there?’ I head to the area behind me, assuming that that is ‘over there,’ and try to locate a seat. Everything is green; green walls, green floors, green chairs. I really am finding it difficult.’
Initial examination
‘Anxiously waiting for a nurse to call my name, my acuity test looms. The nurse shouts my name and I head in the direction of where the voice is coming from, not really waiting for me to follow. I find the room, which is brightly lit once again. She reads my notes. It does state I can only see hand movements but she asks me to read the eye chart anyway, asking me what I can see.
‘“Keep trying,” she demands. I tell her I am unable to see anything, even she is a blur as she blends in with the light coloured wall behind her. She asks me, “How many fingers can you see?” My reply, “none at the moment.” There is no colour contrast. Her fingers blend with her face, both cream in colour, so she holds them against her uniform, waving them. I find it extremely difficult to focus. That little exercise is over with and I’m told to return to my seat, no help is offered. I’m told my next visit will be with the consultant “in the yellow area”… this means nothing to me. I scream in my head “where is the yellow area?” She tells me to follow the yellow line on the floor… I feel like Dorothy in the Wizard of Oz….well maybe not Dorothy, but I am a Dan. Following a yellow line on a yellow floor is a bit tricky for someone with no peripheral vision.’
Waiting area
‘It is obvious that no thought has gone into the design of this eye clinic. The colour, lighting, seating and the rest are not easy to negotiate. Surely if you have different colour areas, then paint the walls that colour and have the carpet that colour, which would be easily identifiable rather than have narrow strips on the floor that I can’t see. You have a light above the door – that’s great if I could see it!
‘I’ve arrived at the yellow area! Waiting to be called, once again, there are many people walking in and out of doors, muffled names being called by consultants and then disappearing quickly back to their rooms. I am not sure what room I will be going into so I wait patiently for my name once again to be called. I’m really not sure in what direction the voice is coming from as I scan my head from side to side.’
Key messages
The trip to the eye clinic can be extremely exhausting leaving, patients drained physically and mentally. They do not just have to contend with people looking into their eyes, but a lack of staff with knowledge of how best to communicate with patients with a visual impairment.
All in all, staff working in the medical field of eyes are truly well-experienced and knowledgeable in the anatomy and health of the eye. However, I believe they lack the fundamental skills to deliver diagnosis in a sensitive way and communicate effectively with patients who have low vision. They would benefit from visual impairment awareness training for all staff working within an eye clinic to raise general understanding and looking at the patient’s needs from a social model of disability and not a medical model.
Education
In an attempt to empower optometrists, ophthalmologists, optical nurses and dispensing opticians. This author has been instrumental in developing a bespoke CET course, enabling optical professionals to see ‘beyond the eyes’. You can find out more information about the course at www.visualisetrainingandconsultancy.com/training/cet-accredited-training-seeing-beyond-eyes.
Optician will be publishing related CET in the coming weeks.
Daniel Williams is the Founder of Visualise Training and Consultancy, working with organisations to improve accessibility for customers and employees with disabilities and a former young person’s mentor with the RNIB.