CBM’s approach to low vision services for children
Dr. Karin Van Dijk, CBM Global Advisor on Low Vision explains CBM’s approach to low vision/ vision rehabilitation services for children.
If an infant or child seems to have vision problems, it is essential the child is seen at an eye health facility as soon as possible. If the child is then diagnosed with low vision, further care is needed.
Providing low vision care to babies, infants and children requires the cooperation and involvement of many different people, such as: the children, their family, their community, eye health professionals at all levels of service delivery and people involved in health, early childhood development and education at community and district level. In addition, local and regional level government officials responsible for eye care, education, and services for people with special needs are important to ensure continuous and sustainable services.
A comprehensive, wholistic approach
CBM considers low vision, also referred to as vision rehabilitation services, as a vital part of comprehensive eye health delivery. It creates an opportunity to deliver quality, inclusive eye health services not only to people with low vision, but to all people with disabilities such as learning disabilities, hearing impairment or cerebral palsy.
Eye health staff providing low vision care in CBM supported programmes are trained to be creative and flexible, have access to a variety of assessment materials and often have more time to work with a client. Children with disabilities benefit from this, as busy outpatient and refraction departments often have limited time per client. Low vision care also creates the need to refer children for further support. This ideally leads to collaboration with, for example, early childhood and education programmes in the area, which in turn may increase early identification and referral to eye health services.
With CBM’s support many eye health staff have received training in low vision both face-to-face and online. We are currently supporting the capacity building of national Trainers and Advisors in low vision of eight countries in Africa.
Decentralising low vision care
People tend to think that low vision care can only be implemented at a tertiary level hospital and preferably at a separate low vision clinic. However, low vision services can be provided at the district level. Currently, low vision services have been integrated in to 40% of CBM’s supported eye health programmes, with the majority including both district and tertiary level services.
In a CBM supported eye health programme in Kenya, a child with vision problems who was ready to start school was identified and referred by a local community health worker. She received prescribed spectacles and a low power hand magnifier; and was trained in the use of these interventions. She started going to her local school where the teacher, supported by a visiting special teacher trained in low vision, checked and advised on the best sitting position in the classroom, demonstrated the correct use of spectacles and devices to learn to read and write, and helped integrate the girl to the classmates and caregivers.