[Inadequacies in the treatment of visual impairment in people with an intellectual disability--who is responsible?]. / Tekortschieten van de behandeling van slechtziendheid bij mensen met verstandelijke beperkingen--wie is verantwoordelijk?

ABSTRACT

A recent retrospective study established that in clients with intellectual disabilities visiting a low vision centre, treatment advice for refractive errors and cataract had not been given in many cases, especially in patients with severe learning disabilities, and that the advice given was not always realised. Due to the retrospective nature of the study design, the reasons for this and the role of the different involved parties could no longer be ascertained. However, the risk of visual impairment and blindness in this specific population is known to be ten-times higher than for the population in general. This gives rise to effects on daily functioning over and above the functional effects of intellectual disability. As refractive errors and cataract are major treatable causes of visual impairment and blindness in this group, optimal treatment should have a high priority. Recent research by our group reveals that implementation of treatment advice by intellectual disability service providers is poor. Important causes are a lack of specific expertise and time under professional carers, management giving insufficient priority to sensory impairments resulting in lack ofsupport, and a lack of pressure by controlling bodies. Furthermore, intellectual disability physicians and general practitioners should far more actively advocate the importance of treatment and effectuate ophthalmologic referral. A practical ophthalmologic guideline for cataract surgery in this population may facilitate a harmonisation of the indications for surgery.