Definition

In the UK, the statutory definition of blindness refers to persons who "are so blind as to be unable to perform any work for which eyesight is essential". When a patient's vision falls below this level, registration as a blind person can be considered. This is a voluntary process, which allows the patient access to the social services for the visually handicapped, as well as certain tax concessions. Registration is usually initiated in the hospital clinic. Some patients are referred by their general practitioners or social workers for registration by the ophthalmic specialist. A special form is completed and copies go to the patient, the general practitioner, the social services department and the Office of Population and Censuses.

Certain guidelines are laid down when considering blind registration; the visual acuity should be less than 3/60 in the worse eye but if the field of vision is constricted, the visual acuity might be better than this. Patients whose vision is not bad enough for blind registration but none the less have significant visual handicap can have their name placed on the partially sighted register. In these patients the binocular vision should normally be worse than 6/18. Patients sometimes erroneously claim the benefits of the partially sighted because they have only one eye, even though the remaining eye is normal. When the vision with one or both eyes is 6/18 or better, the patient is not usually considered to be partially sighted. When one eye is completely lost through injury or disease, the amount of incapacity is set for medicolegal purposes at about 10%. In actual fact, the amount of incapacity depends a great deal on the age of the patient. A child can adapt to a remarkable degree to being one-eyed, even to the extent of being able to perform with skill at ball games. Adults who become one-eyed find difficulty in judging distances or performing fine manual tasks. More importantly, a number of occupations are specifically barred to those whose vision is poor in one eye.

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