Certificate of Visual Impairment

CVI Forms for England, Scotland, Wales and Northern Ireland

CVI England

CVI Scotland

CVI Wales

CVI Northern Ireland

Paediatric CVI Form (to be completed in addition to the standard form). This allows easier and more precise classification of paediatric eye disease and also allows international comparison of data. Ophthalmologists are requested to complete the form in addition to the current CVI and return them together in the usual way

August 2007 - Update to the CVI Form

The diabetic eye disease section has been split into two parts; retinopathy and maculopathy on the CVI form. The new form can be downloaded from the Department of Health website :-

http://www.dh.gov.uk/en/Policyandguidance/Healthandsocialcaretopics/Optical/DH_4074843

A specimen CVI form can be viewed here.

There is also an article in the Medical Director's Bulletin for this month. This can be downloaded below.

Medical Director's Bulletin - August 2007

The address for returning completed CVI forms has also changed slightly. In future the forms should be returned to:

The Royal College of Ophthalmologists
c/o Certifications Office
Moorfields Eye Hospital
City Road
London
EC1V 2PD

Any forms sent to the College directly will be forwarded on to the correct address.

Identification and Notification of Sight Loss

(Text taken from the Department of Health, Eye Care Services website)

Final changes to registering patients as severely sight impaired (blind) or sight impaired (partially sighted). Department of Health gateway approval number 5358 applies where relevant.

The Certificate of Vision Impairment, CVI 2003 (Gateway reference 2115) and associated documents have been updated in consultation with a wide range of professionals, other government departments and voluntary organisations working in the field of visual impairment. We would like to thank all those people who sent in comments on the documents and process. It is clear that the system is working well in some parts of the country and is being used as an opportunity to improve the integration of health and social care.

From 1 September 2005 hospital eye clinics will need to use the revised Certificate of Vision Impairment (CVI) to certify patients as severely sight impaired or sight impaired. The form BD8 should no longer be accepted. When signed by a consultant ophthalmologist, the CVI will now be the formal notification required by councils with social services responsibilities (or their agents) to register someone as sight impaired or as severely sight impaired.

Articles describing the background to these changes are at: http://www.sightlossmatters.com (under the 'Registration of sight loss in England').

• sightlossmatters.com (opens new window)

Certificate of Visual Impairment, Guidance Notes and Related Documents

1. The CVI (which has been slightly amended in August 2007).

• Certificate of Visual Impairment (PDF)
  

Hospital eye services can download the Word version of this form for tailoring with their own contact details from the NHSweb link below, or by emailing:

• OPDEnquiries@dh.gsi.gov.uk (opens new window)
• Download a Certificate of Vision Impairment (for NHSweb users) (opens new window)
• Email OPDEnquiries for a CVI (hospital eye services only) (opens new window)

A secondary purpose of the CVI is to collect data on the incidence and causes of severe sight problems. The current arrangements about where hospitals should send a copy of the form for this purpose are contained in the Explanatory Notes.

2. Explanatory notes with general instructions and with detailed matters for ophthalmologists to consider when filling in the certificate.

• Explanatory notes for consultants ophthalmologists and hospital eye clinic staff (PDF, 53K)

3. Referral of Vision Impaired Patient (RVI): these can be issued by eye clinics. They can be used to alert social services to the needs of people with vision impairments in a timely manner and in advance of certification.

• Download Referral of Vision Impairment (Word version) (DOC, 45K)

4. Information for social services and for optometrists:

• The identification, referral and registration of sight loss: action for social services departments and optometrists, and explanatory notes (PDF, 60K)

5. In response to the consultation feedback the Letter of Vision Impairment will now be replaced by a Low Vision Leaflet (LVL). The first document is a pdf document and the other document, that you can download, is in Quark format. In order for a local authority to localise their own LVL, they will need to use Adobe Acrobat Professional or Quark XPress.

• Download Low vision leaflet in Portable Document Format (PDF, 460K)

Article from College News Spring 2007 about the importance of registration

There is a worrying drop in the number of CVI certifications as the graph below demonstrates. The reasons for the decline is not clear and we would like feedback from College members about the process (president@rcophth.ac.uk) There will be a poster associated with the CVI project shown at the Annual Congress and members are invited to discuss their concerns with Catey Bunce, the lead statistician, and her co-workers.

The Paediatric Subcommittee have been working with Dr Bunce on a form to collect epidemiological information about children with visual impairment which will shortly appear on the College website.

A member of the College's Lay Advisory Group gives her perspective as a social worker:

Misconceptions about registration

In 35 years of working with blind and partially sighted people and their supporters, there is one issue that invokes a sense of despair. Each year one or two people would ask why registration was not deemed appropriate for individuals whose visual impairment was caused by 'brain damage'. One man summed it up: 'Surely blind means blind?'

In time I learned that there were certain 'groups' of people where registration was not always discussed:

• People with cerebral visual impairment (mainly people with cerebral palsy) - I was sometimes informed that GPs or optometrists would not refer such people to ophthalmologists because 'their eyes are perfect'. Occasionally a relative would announce that an ophthalmologist had said they could not register someone because 'there is nothing wrong with their eyes'.

• People with severe learning disabilities may not be registered, despite family and professionals knowing they were born with a visual impairment. There may be many reasons for this, but mostly commonly I was told that registration is 'irrelevant' to the individual as 'they are getting all the benefits to which they are entitled'. This is untrue. It is important that people with severe learning disabilities are registered. Much can be achieved when they receive the right help.

• People with advanced dementia affecting vision. Involvement by rehabilitation officers for the visually impaired may prevent people from becoming even more confused by their environment. Relatives are often keen to obtain all the appropriate benefits, including the blind person's tax allowance - especially when people are living in expensive nursing homes.

The Blind Person's Act 1920 and subsequent legislation allows that:

"People who are blind/severely sight impaired or partially sighted/sight impaired are entitled to be registered - regardless of the cause of their sight problem".

Help from a rehabilitation officer for the visually impaired can make a substantial difference to people's quality of life. Registration is a 'passport' to services. People need this help. They have a right to it!

Gill Levy

Download Article

College Statement on CVI Forms

In 2003, the self-carboning form for certifying blindness or partial-sightedness (Form BD8) was replaced by the Certificate of Visual Impairment (CVI). The terms "partial sight" and "blindness" were replaced by the terms "sight impaired" and "severely sight impaired", though the guidance for the level of vision at which someone may be certified for either category is unchanged.

Since 2003, there has been a significant fall in most areas of the country in the numbers of patients certified by ophthalmologists as sight impaired and severely sight impaired. The reasons for this are unclear, but it is unlikely that it is due to a genuine fall in the incidence of registrable sight impairment, or due to the fact that patients can request a home visit from a sensory disability worker without being registered.

Concern has been expressed that there may be a considerable number of people who would benefit from being registered as sight impaired or severely sight impaired, who are not currently registered. If this is the case, not only are people missing out on a valuable source of assistance in coping with sight loss, but valuable demographic data on the causes of visual impairment is being lost.

The College believes that an important component of good clinical care by ophthalmologists is the offer of a Certificate of Visual Impairment to eligible patients. The College encourages its members to promote the uptake of the CVI amongst patients who are likely to benefit from it and to facilitate the process of registration as far as it is in their power to do so.

Richard Smith
Chairman of Professional Standards
April 2007

Download Statement


Page updated 9 September 2010 (BB)