help please

CVI AND CSSI/B in England

The Certificate of Visual Impairment

is Certainly Very Important to

anyone who has significant sight loss.

It would appear that many people with a significant

degree of visual impairment are totally

unaware of it. Even more worrying

it appears that not all ophthalmologists are

aware of them. Those who know

about the CVI do not seem to appreciate

how important it is for their patients.

The CVI is the royal road to registration and the subsequent support, and literally puts you on the map as far as the sight loss world is concerned.

Curiously , some people have been known to

refuse a certificate.

Up to 12% of certificate holders have

not gone on to register as sight impaired or

severely sight impaired/blind.

In addition to this there is one estimate that

only 49% of patients who qualify for a CVI actually

have them.

This is a shocking state of

affairs and the implications for

the sight loss support sector are


If we look at the role of the CVI and the rationale

behind it, then the grounds for dismay

are even more firmly rooted.

From the guidelines to ophthalmologists and

eye clinic staff published in 2017.

Purpose of the CVI form

1. The CVI formally certifies someone as sight impaired (previously referred to as partially

sighted) or as severely sight impaired (previously referred to as blind). With the

permission of the patient the CVI is shared so that their local authority or an organisation

working on their behalf, is able to make contact to offer and explain the benefits of

registration on a local sight register and to ensure support and services are accessible as

appropriate. 2. Sight loss can have a significant impact on a person’s independence and wellbeing. If the

person is not known to social services as someone with needs arising from their sight

impairment, the CVI acts as a formal referral for a needs assessment. Consequently, the

CVI should be seen as a significant step on the sight loss pathway, enabling people to

access support to help them retain or regain independence. Certification should therefore

not be seen as the end of the treatment journey for patients but as a gateway to support

and services.

3. On receipt of a CVI, in addition to providing an assessment of the patient’s social care

needs, the local authority or an organisation working on their behalf should also contact

the patient to offer and explain the benefits of registration. Registration is voluntary, and

whilst it is essential to obtain some benefits and concessions, it is not a prerequisite for

accessing support from social services.

4. Hospital clinic staff should explain the importance of certification and the sharing of

information with their local authority, their GP and the Royal College of Ophthalmologists

Certifications Office at Moorfields Eye Hospital. If the patient still does not consent to

sharing information they should be made aware they may miss out on valuable support

and information.

5. Completing and sending off the CVI in a timely manner is not only beneficial for the

patient but will enable community health and social care agencies to plan appropriate

services as part of local strategies such as falls prevention or loneliness and isolation.

6. If the patient has also provided consent to share the CVI form with the Certifications

Office at Moorfields Eye Hospital, the CVI will be used to record diagnostic and other

data that is used for epidemiological analysis and reported via an NHS England Public health indicators.

it is clear that the intentions

are there but the execution is on the whole poor.

Over the years I have met many

people who knew nothing about

the CVI or if they did had

to insist on one being issued.

I am currently carrying out a survey

to try and get an indication as to whether

this is typical or not. The data

so far indicates that the majority

of people have to ask and that on the whole consultants

are not very pro-active in offering the


I would be very grateful if anyone who reads this could help me collect the data.

If you , or anybody you know, has a CVI could you please provide two bits of information.


The year the certificate was issued


Whether the certificate was offered or had to be asked for.

Please contact me on