Unclear Low Vision Registration Process Limits Patients’ Access to Care

Patients and clinicians blame an unclear low vision registration process for creating barriers to care for individuals with vision impairment.

Unclear low vision registration processes may create confusion among individuals with visual impairment or blindness and limit their access to social care support benefits that have been designated for their use, according to a study published in Eye.

The UK-based study included patients with visual impairment (n=17), optometrists (n=4), and eye clinic liaison officers (ECLOs; n=4). The study team performed 30 to 45 minute semi-structured interviews and explored emerging themes associated with care experiences, access to support, and the value of information provided by clinicians and other health care workers.

“It is important to note that the sight loss pathway starts long before a patient is certified and registered—it starts when patients present themselves with an eye condition,” the study authors explain. “It is important that patients are given appropriate care and advice early in the sight loss journey and signposted to support services if needed.”

Overall, participants reported experiencing an unclear low vision registration process and difficulty accessing services. Barriers to care include disagreements between clinicians on what constitutes criteria for registration and long wait times to obtain services. Some patients also reported a failure on the part of optometrists and ECLOs to inform them of available benefits, and others reported not seeing any value in these services.

The ECLOs acknowledged that timeliness was a concern for initiating the low vision registration process, and acknowledged patients could not access care until completing this process. Optometrists varied in their responses — some reported that it was not within their role to get involved in the process. One optometrist admitted they needed better training.

The researchers acknowledge a “lack of standardization around the CVI/RVI and registration processes which needs ‘joining up’ so that, after certification, patients
can access the support they need without having to undergo further bureaucratic processes, thereby reducing the risk of them falling through the cracks and out of the system, thus missing out on vital support, services, and benefits.”


Pardhan S, Driscoll R, Ingleton H, et al. Confusion around certification of vision impairment (CVI) and registration processes—are patients falling through the cracks? Eye. Published online April 19, 2023. doi:10.1038/s41433-023-02520-0