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Severe visual Impairment
In order to be entitled to the higher rate of the mobility component under this criteria, an individual must:
- Have been certified as severely sight impaired or blind by a consultant ophthalmologist; and
- Have a severe visual impairment (Scottish Adult DLA regs, reg. 8(2)(c))
An individual has a severe visual impairment for the purpose of Scottish Adult DLA if:
- they have visual acuity, with corrective lenses if necessary, of less than 3/60 Snellen (or equivalent) (Scottish Adult DLA regs, reg. 8(5)(a) and 8(6)(b)); or
- they have o visual acuity of 3/60 Snellen (or equivalent) or more, but less than 6/60 Snellen (or equivalent) with corrective lenses if necessary and o a complete loss of peripheral vision and o a central visual field of no more than 10o in total (Scottish Adult DLA regs, reg. 8(5)(b) and 8(6)(b)) ; or
- they do not fall into group (a) or (b) but they have insufficient vision to enable them to be independently mobile in familiar places outdoors (Scottish Adult DLA regs, reg. 8(5)(c))
For the purposes of determining whether an individual has a severe visual impairment :
- where the person has both eyes:
- the combined visual acuity should apply
- the combined visual field should apply
- visual acuity is measured using the Snellen Scale or an equivalent test (Scottish Adult DLA regs, reg. 8(6))
There may be circumstances that an individual is unable to provide supporting information of the above, such as:
- They have yet to receive a letter confirming their condition from their ophthalmologist,
- They are waiting for appointments or test results,
- They may have misplaced or lost the supporting information.
This list is not exhaustive.
If an individual is unable to provide the supporting information the case manager should still consider whether the individual meets the severe visual impairment criteria based on other supporting information provided by the individual. Due to the nature of the criteria for severe visual impairment, we would require that alternative supporting information is medical supporting information, provided by a professional such as an ophthalmologist.
The case manager should request a clinical case discussion with a practitioner if they are in any doubt about if an individual meets the severe visual disability criteria.
Example: an individual has visual acuity of less than 3/60 on the Snellen scale (or equivalent)
Gerard is 60 years old and receives the lower rate of the mobility component and the middle rate of the care component of Scottish Adult DLA. Recently, Gerard has had an episode of acute glaucoma and as a result his eyesight has been severely affected.
Following surgery to address the acute glaucoma, Gerard is assessed by an ophthalmologist who finds that Gerard’s visual acuity is 1.4 logMAR, even when he is wearing his glasses. The ophthalmologist does not expect that Gerard’s eyesight will improve substantially due to his age. As 1.4 logMAR equates to 6/152 on the Snellen scale (converted using NHS Scotland Snellen-Logmar Calculator) and this is less than 3/60, Gerard’s ophthalmologist provides him with a Certificate of Visual Impairment (CVI) confirming that he is severely sight impaired.
Gerard reports to Social Security Scotland that he is now severely sight impaired. The case manager receives the CVI from Gerard’s ophthalmologist to confirm this diagnosis, and awards the higher rate of the mobility component in addition to the middle rate of the care component.
Example: the individual’s visual acuity is above 6/60 on the Snellen Scale but they have insufficient vision to enable them to be independently mobile in familiar places outdoors
Robin is 46 years old and currently receives the lowest rate of the care component of Scottish Adult DLA. She was recently diagnosed with Retinitis Pigmontosa (RP) after experiencing issues with her eyesight in very bright or dimly-lit conditions. This means that Robin experiences difficulty navigating around outdoors both during the day and at night, even in her local area, and is at risk of walking into obstacles or into the road if she goes out on her own.
Robin therefore needs her partner to accompany her for when she goes to appointments, to the shops or to socialise with friends. As Robin’s partner works full time, this means she has to plan any trips out around their working hours. At home, where the lighting is controlled, ambient and consistent, Robin is able to move around safely as the impact of RP is less profound in ambient lighting.
At her most recent consultation with her ophthalmologist, Robin was tested using the ‘Snellen’ test, and was found to have visual acuity of 6/38, a complete loss of peripheral vision and a central visual field of less than 10o . Her ophthalmologist was satisfied that due to RP and a restricted visual field, Robin has insufficient vision to enable her to be independently mobile outdoors, even in familiar areas. At Robin’s request, her ophthalmologist provides a CVI confirming that she is severely sight impaired.
Robin reports that she has become severely sight impaired, and provides a copy of the CVI as supporting information when reporting the change. The case manager awards Robin the higher rate of the mobility component after fulfilling the backwards test, as well as maintaining the lowest rate of the care component of Scottish Adult DLA