Barriers to sight impairment certification in the UK: the example of a population with diabetes in East London.

BACKGROUND: This study assessed the barriers to sight impairment certification in the East London Borough of Tower Hamlets amongst patients attending the Diabetic Retinopathy Screening Service (DRSS). METHODS: All patients who attended DRSS between 1stApril 2009 and 31st of March 2010 and whose recorded best corrected visual acuity (BCVA) at DRSS fulfilled the requirements for sight impairment in the UK were included. An additional 24 patients whose general practitioners (GPs) reported them to be certified blind due to no perception of light (NPL) vision were re-examined to ascertain the reason for certification, and their potential social and visual aids needs. RESULTS: 78 patients were identified with certifiable vision and were reviewed: 10 deceased in the preceding 12 months; 60 were not known to be certified. Of these, 57 attended further assessment, 27 were found to have non-certifiable vision, 9 were referred for further interventions, 9 were certified and 9 were found to be eligible, but declined certification. Five patients were registered due to diabetic eye disease.Of those 24 reported by the GP of NPL vision, only 4 had true NPL, the rest had usable vision. Only two of them were certified blind due to diabetes. CONCLUSIONS: Our data shows that sight certification in patients with diabetes might be underestimated and these patients often have non-diabetes related visual loss. We propose that data on certifiable visual impairment could serve, along with existing certification databases, as a resource for quality of care standards assessment and service provision for patients with diabetes.

Deslocamento de deficientes visuais em vias públicas da região metropolitana de Belém/PA / Mobility of visually impaired people in streets of the metropolitan region of Belém/PA

Introdução: Em uma estrutura urbana, o sistema de deslocamento é o articulador das atividades econômicas, culturais e sociais. Porém,alguns gestores deixam de construir em seus municípios uma infraestrutura de transporte adequada para a circulação de pedestres,em especial de portadores de necessidades especiais (PNE). Objetivo: Levando-se em consideração a dificuldade de acessibilidade existente na mobilidade urbana desses indivíduos e a condição real das calçadas na maioria das cidades brasileiras, faz-se necessário obter informações sobre possíveis alterações que o piso possa provocar no sistema locomotor durante a marcha. Material e métodos: Foram coletados dados por meio de entrevistas semiestruturadas (questionários de opinião) a 54 deficientes visuais a fim de verificar o grau de satisfação com as calçadas de Belém e com a utilização do piso com sinalização tátil de alerta e tátil direcional da Prefeitura Municipal de Belém. Resultados: Foi encontrado, entre outros resultados, que a maior parte dos investigados sente alguma dificuldade em se deslocar pelas calçadas da cidade e a significativa minoria considera ruim o deslocamento na calçada cidadã. Conclusão: Pode-se concluir que a dificuldade de deslocamento pelas calçadas da Região Metropolitana de Belém afeta enormemente aos deficientes visuais.

Introduction: In an urban structure, the transportation system isthe articulation of economic, cultural and social activities. However,some managers fail to build in their towns an adequate transportation infrastructure for pedestrian’s circulation, especially people with special needs (PSN). Objective: Taking into account the difficulty of existing accessibility in the urban locomotion of these individuals and the actual condition of sidewalks in most Brazilian cities, it is need to obtain information about possible injuries that pavement may cause in the locomotor system during gait. Method: Data were collected by means of semi-structured interviews. The questionnaires were distributed to 54 visually impaired PSN, to verify the level of satisfaction with the sidewalks of Belém and with the tactile warning and tactile directional signage of local government of Belém. Results: The results show that most of the interviewees have some kind of difficulty to move around the sidewalks of the city and the minority believes that the urban sidewalk is bad to move around. Conclusion: We can conclude that visually impaired users in the metropolitan region of Belém are enormously affected due to difficulty in travelling on the sidewalks.