Better sight

older oriental woman reading outside 

This leaflet was written in association with the Royal National Institute of Blind People (RNIB).

This leaflet was printed in January 2009. Every effort has been made to ensure that the information contained in this leaflet is correct. However, things do change, so it is always a good idea to seek expert advice on your personal situation.

Contents

As we grow older, our sight tends to change naturally, so that almost everyone over the age of 65 needs to wear glasses. Regular eye tests and suitable glasses will increase the chances of your sight remaining good.

Unfortunately, some people’s sight will continue to get worse so that they have difficulty seeing even with glasses. But if you get the right help and advice, worsening sight shouldn’t stop you from leading a full and independent life.

Eye tests

An eye test is not just a test to see whether you need glasses; it is a vital check on the health of your eyes. Eye diseases can often be detected at an early stage, usually before you have even noticed anything is wrong. This is very important as early treatment may stop the eye disease getting any worse and prevent the damage it would cause to your vision.

It is recommended that you have an eye test at least every two years, and more often if you notice any change in your vision.

Where to have an eye test
Optometrists, who are often called opticians or ophthalmic opticians, usually carry out eye tests.

There is an optician on most high streets. But you can ask to have your eyes tested at home if you are unable to leave the house, or find it hard to get out because of illness or disability.

For more information, RNIB produces a useful factsheet called Getting an Eye Test.
 
Paying for eye tests
If you are aged 60 or over you can have a free NHS eye test at any opticians. If you need a NHS home visit, this should be free as well. Take along something which proves your age, such as a passport, driving licence or NHS medical card, and fill out the form which the optometrist will give you.

If you are under 60 you will usually have to pay for your eye test, but there are some exceptions. For more details contact the RNIB helpline.

Further eye checks and treatment
If your eye test reveals any condition that needs treatment or further investigation, you will probably be referred to your doctor. If necessary, your doctor can then arrange for you to see an eye specialist (ophthalmologist) in a hospital.

If the optometrist finds something which they think needs to be seen quickly by the hospital, then they can often arrange for you to be seen in the casualty department on the same day.

It is important to see your doctor regularly for a general health check as other conditions and medicines can affect your sight. 

 

Glasses and contact lenses

Glasses and contact lenses will enable you to see as well as possible.

Where to buy glasses and contact lenses

If your eye test indicates that you need glasses, the optometrist is legally obliged to give you a prescription. This will detail the type and strength of lenses you need. You can take this prescription and use it to buy glasses or contact lenses from any supplier. 

Different types of glasses and contact lenses 

An optometrist can advise you on the most suitable lenses for your needs. There’s a wide choice of different lenses – bifocals, trifocals, and varifocals – which can help you see in different situations. Lenses can be tinted to cut down on glare. 
 
Whatever glasses you choose, it is important to remember to keep them clean. When you are not using them, keep them in a protective case or cover to avoid scratches. Never place glasses with the front of the lenses face down on a surface; this may cause scratches to your lenses.

Help with the cost of glasses and contact lenses 

Some people are entitled to a NHS voucher to help pay for glasses or contact lenses. You are entitled to a voucher if:

  • You or your partner receive the guarantee credit part of Pension Credit, Income Support, Income-based Jobseeker’s Allowance, Income-related Employment and Support Allowance or, in some circumstances, Child Tax Credit or Working Tax Credit; or
  • You have been prescribed complex or powerful lenses; or
  • You receive a War Disablement Pension and you need your glasses because of the medical conditions you are paid the pension for. For more details on how to use the voucher under the War Pensions scheme call the Service Personnel and Veterans Agency on 0800 169 2277.

The value of the voucher depends on the kind of glasses you need and can be used at any opticians. If, this does not cover the full cost of the glasses you want, you will need to make up the difference yourself. 
 
If you have an HC2 or an HC3 certificate from the NHS Low Income Scheme, ask your optometrist about your entitlement to a voucher. To find out more about this scheme or the vouchers, ask your optometrist for leaflet HC11 Help with Health Costs. For further advice call the RNIB helpline.

Ready-made glasses

You can buy ready-made reading glasses from a number of outlets including supermarkets. However, these should only be used as a temporary, short-term solution as it is rare for both your eyes to need exactly the same amount of correction. 
 
It is recommended that you have an eye test to check the health of your eyes and to find out which glasses are right for you. 

Lighting

Compared with the amount of light a healthy eye needs at 20 years of age, twice as much is usually required at 40 and three times as much at 60. A good overall level of lighting is therefore very important to help you make the best use of your eyesight.

Natural daylight is a very important source of light but a surprisingly large amount is lost through dirty windows or curtains. To increase levels of daylight in your home:

  • keep the windows clean;
  • pull curtains back as far as possible;
  • keep net curtains clean, or remove them altogether; and
  • paint window frames and walls a light colour.

Vertical and horizontal blinds can be a good alternative to curtains. They allow you to control the amount of light coming into your home. You can use blinds to reduce glare and to direct light at the angle most useful for you. You should also ensure that you have adequate electric lighting. Good lighting is particularly important at the top and bottom of stairs to help you avoid falls. 

For reading or close work, make sure you have direct light from a flexible table lamp, positioned in front of you, shining down on to your book or work. Fluorescent lamps are particularly efficient as they produce a lot of light but very little heat.

Serious sight loss

 

Some people may develop eye conditions such as glaucoma or cataracts which may mean that even when they are wearing the right glasses or contact lenses they may not be able to see very well.

It can be difficult to come to terms with serious sight loss and people often experience a number of emotions, including anger, grief and loss. This is a natural reaction, and counselling can sometimes help. Ask your doctor or social worker if counselling is available in your area, or contact the RNIB helpline for information.
 
Optical aids
There are many different optical aids which can help people with serious sight loss see better. The simplest optical aids are special magnifiers. These can make things look bigger so that you can perform tasks you find difficult because your eyesight has deteriorated. Magnifiers may be held in your hand, have their own stand or they may be built into your glasses.
 
Reading frames or typoscopes are useful to reduce glare and concentrate vision on the area of print being read. You can make your own very easily by cutting out an oblong from a piece of black card.
 
It is important that you get optical aids which are suitable for your particular eye condition and for a given activity. It is likely you will want to do different things such as reading the newspaper, watching television, or reading a bus number, so you may find that you need several different types. 
 
For advice on optical aids, you should ask your doctor or eye specialist (ophthalmologist) to refer you to a low vision clinic.
 
Low vision clinics
Low vision clinics are usually based in hospitals. Specialist staff at the clinic can suggest ways you can make the best possible use of the sight you have and assess which optical aids would help you most. This equipment can nearly always  be supplied to you on loan. Ask your doctor or ophthalmologist if there is one in your area they can refer you to.
 

Practical aids for daily living


If you have problems with your sight there are lots of gadgets and equipment which can help you lead an independent life. For example, a talking watch, or one with a large face, will make telling the time easier and talking kitchen scales can help with cooking.

You may wish to adapt or adjust your computer to make it easier to use, perhaps by installing magnification or screen reader software, or getting a larger monitor. AbilityNet has information on low cost and free solutions. You can visit its website at www.abilitynet.org.uk or call free on 0800 269 545.

To find out more about practical aids, contact the Disabled Living Foundation on 0845 130 9177. RNIB and the Partially Sighted Society can also advise you on what is available. 

Rehabilitation workers
Rehabilitation workers can give you practical advice on how to use your low vision aids so that you get the maximum benefit from them. 
 
They can also advise on ways to make life easier at home – including how to use lighting effectively and practical aids for daily living. They are also able to advise you on how to adapt your kitchen and other areas of your home so that it’ is easier to manage your daily routine.
 
Rehabilitation workers are usually employed by the social services department at your local council. In some areas they are employed by local voluntary societies for people with poor sight. If you have difficulties finding out about low vision clinics or rehabilitation workers in your area, contact the RNIB helpline.
 
Large print books and games 
Large print books are available through local libraries. You can also get a variety of large print games such as playing cards, bingo sets, Monopoly and Scrabble. For more information contact the RNIB helpline.

Talking books and newspapers
RNIB provides a National Library Service of over 40,000 titles in Braille, moon, giant print and audio format. Contact the RNIB helpline for more details

Another organisation, Calibre Audio Library, runs a free library service for anyone who has difficulty reading print books. It has an extensive range of books on cassette tapes and will deliver the tapes to your home. For more information contact Calibre Audio Library, New Road, Weston Turville, Aylesbury, Bucks HP22 5XQ; tel: 01296 432339; web: www.calibre.org.uk

Newspapers and magazines are available on cassette tape through most libraries. The Talking Newspapers Association (TNAUK) can also supply them on cassette tape, computer disk, CD-ROM, or by email. For more information contact, TNAUK, National Recording Centre, 10 Browning Road, Heathfield, East Sussex TN21 8DB; tel: 01435 866102; web: www.tnauk.org.uk

British Wireless for the Blind Fund can supply radio and audio sets to people who are registered as sight impaired or seriously sight impaired, and in financial need. For more information call 01622 754757

 

Registering as sight impaired

People with serious sight loss may register with the local council as sight impaired or seriously sight impaired (this used to be known as registering as partially sighted or blind). Being registered as seriously sight impaired doesn’t usually mean you cannot see at all; most people who are registered do still have some useful vision.

You do not have to register, but it can offer advantages. For example, you will be automatically entitled to concessions such as a reduction in the price of your TV Licence if you are registered seriously sight impaired. Your claim for disability benefits may be strengthened if you are registered as sight impaired or seriously sight impaired. The RNIB helpline (0303 123 9999) can give you advice on this.

If you think you need help with day-to-day tasks or that you might be at risk of an accident you can contact your local social services for an assessment, even if you are not registered (in Scotland contact your social work department; and in Northern Ireland contact your health and social services trust). Your optician can give you a letter of visual impairment (LVI) which gives you the details you need.

How to register
Ask your doctor to refer you to an eye specialist (ophthalmologist). They will examine your eyes to assess whether you are eligible to be certified as sight impaired or seriously sight impaired (partially sighted or blind). If you are eligible, the eye specialist will complete and sign a special form. With your permission, a copy will be sent to your local social services. They should then visit you to talk about being included on the register and the needs you have. For more information, contact RNIB.

Welfare and disability benefits
If you have difficulties with your sight, you may qualify for disability benefits such as Disability Living Allowance or Attendance Allowance, even if you aren’t registered as sight impaired or seriously sight impaired (blind or partially sighted).
If you are living on a low income, you may also be entitled to benefits such as Pension Credit or Housing Benefit. You can find out about these benefits in Age UK’s free advice leaflets.

If you would like to check whether you are receiving all the benefits you are entitled to, call the RNIB helpline (0303 123 9999)

 

Common eye conditions

Some eye conditions cause peoples’ eyes to deteriorate so that they have difficulty seeing even with glasses. This section looks at the most common eye conditions in later life.

Cataract
This is a condition which makes the lens inside the eye cloudy instead of clear. If you have a cataract you may find that your vision seems misty and blurred, especially in strong sunlight. In most cases this can be treated easily with surgery.

For more information, RNIB produces a leaflet called Understanding Cataracts

Macular degeneration
This is a condition which affects the macula, a part of the retina at the back of the eye. The macula enables us to see detail and appreciate colour. With macular degeneration, your central vision is damaged, making it hard to read and recognise faces. However, there are a variety of optical aids available which can help you to make the most of your remaining sight.

RNIB produces a leaflet called Understanding Age-related Macular Degeneration. There is also a group called the Macular Disease Society, which can offer support and information on the condition. It can be contacted at: Macular Disease Society, PO Box 1870, Andover SP10 9AD; helpline: 0845 241 2041; web: www.maculardisease.org

Glaucoma
Glaucoma is the name for a group of eye conditions involving damage to the optic nerve at the back of the eye. It is usually caused by raised pressure in the eye. Glaucoma can lead to ‘tunnel vision’ but treatment, either with eye-drops or surgery, can be very successful if started early.

If you have glaucoma you should tell your relatives as it can run in the family. People over 40 who have a close relative (parent, brother or sister) with glaucoma can also claim free eye tests.

For further information, RNIB produces a useful leaflet called Understanding Glaucoma. There is also an organisation called the International Glaucoma Association which you can contact for more information and advice. Its address is Woodcote House, 15 Highpoint Business Village, Henwood, Ashford, Kent TN24 8DH; helpline: 01233 648170; web: www.glaucoma-association.com/

Diabetic retinopathy
This is the term often used to describe changes at the back of the eye which may cause sight problems in people with diabetes. Often you won’t notice any changes in your vision in the early stages, so regular eye tests are very important. In time your vision may become blurred and patchy. Laser treatment is usually given to stop this condition getting any worse. You can also help to stop your sight deteriorating by controlling your diabetes.

You can find out more from the leaflet Understanding Eye Conditions Related to Diabetes which is available from RNIB. Information about diabetes and sight loss is also available from Diabetes UK, Macleod House, 10 Parkway, London NW1 7AA; Careline: 0845 120 2960; web: www.diabetes.org.uk

Useful contacts

RNIB Cymru
Trident Court
East Moors Road
Cardiff
CF24 5TD
Telephone: 029 2045 0440
Fax: 029 2044 9550
Email enquiries: CymruEvents@rnib.org.uk

RNIB Cymru works for the 100,000 people in Wales with serious sight loss.
It provides practical solutions to everyday challenges, campaigns for the inclusion of people with sight loss and runs pilot projects within our communities. RNIB Cymru also promotes eye health by running public health awareness campaigns andworking in partnership with organisations across Wales to provide local services. 
 

 


 
Advice line:
08000 223 444
 

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