Over the past few weeks, there have been two disturbing articles in the press that have caught my attention. The first, a case of a sight-impaired driver involved in an incident with a cyclist that resulted in the tragic death of the cyclist. The second, an article about banning the parking of cars partly on pavements. I will not comment on either case specifically as I do not have anywhere near the full information on either case, but I do wish to look at the ramifications of incidents such as these in the light of disability.
There can be no denying that in this modern, fast-moving world, life for sight-impaired people can be confusing and intimidating. Sight impairment can manifest itself in many ways, from the loss of peripheral vision, with conditions such as glaucoma or retinitis pigmentosa, to the loss of central vision, with conditions such as age-related macular degeneration or cataract. With peripheral vision loss, the brain is very clever in filling in the lost areas with ‘grey’ infill, which gives the person a false sense that they can see fully. No wonder that they trip, fall, or react suddenly to obstacles or things approaching them at speed. Altered depth perception or spatial awareness may well only enhance the feeling of insecurity that these incidents may bring.
Why should any of this concern optometrists or dispensing opticians, or anyone involved in the world of sight care and eye health? The simple fact is that our remit, in terms of looking after people’s sight, should extend well beyond the task of correcting vision or seeking to check for abnormality. I believe we have a social responsibility to ensure that our patients and the wider community live in a safe environment. We have little or no difficulty deciding whether someone is a danger driving with visual impairment and taking the necessary action to ensure that danger is neutralised (the danger, not the individual themselves). But do we take our responsibility any further than that?
One of the commonest areas for falls in the home is the stairwell. These parts of the house are notoriously poorly lit. When was the last time any of us really took an interest in the layout of someone’s house and advised them on the correct lighting for the house? I have no doubt we have offered generic advice, but do we offer a service of visiting the house to physically check for problems and offer solutions? Is there any member of the practice team trained to offer this support? Is this something we have ever considered doing? I accept many will say this is not practical or possible. However, there are other ways we should be making use of our skills.
There will be some practitioners who are actively involved in their local low vision groups serving the community. I hope every Local Optical Committee (LOC) has close contact with all such groups and is aware of the concerns confronting sight-impaired and severely sight-impaired members of their community. For many years, I was a trustee of our local low vision service and became extremely aware of the daily problems that this group of people faced. One of the fundamental problems many of this group face is the issue of blocked pavements.
Obstacles placed on the walkway that impede straight ahead walking can be of huge concern. One look along many high streets or in shopping malls will immediately show shop A boards littering walkways and obstructing them. These are a real nuisance to people with visual impairment and can often lead to accidents. There will be many businesses that are unaware their signage presents a very real safety problem to visually impaired people in their community, but should it not be the role of people such as us to educate our local communities of these dangers? We can do this either by personal contact or via our LOCs or by supporting our local visually impaired groups in campaigns to rid the streets of A boards and other obstacles, including vehicles parked blocking pavements.
As professionals who understand visual impairment, we are ideally placed to look around our local communities and actively seek to make them safer places for the visually impaired. Being eye care practitioners does not exempt us from visual problems in the future and it just may be you or me one day who trips over a pavement obstruction and injures ourselves.
Why not look around your local streets through the eyes of the visually impaired and see what you can do to make your communities safer? And, if you have an A board outside your practice partially blocking the pavement, why not start there?
