A review of the evidence that people with learning disabilities experience eye health inequalities: What policies can better ensure an equal right to sight?

BackgroundPeople with a learning disability experience challenges accessing primary health care services, including eye care services.MethodsEye care needs of people with a learning disability, and how well they are met by existing services in England, were explored. Barriers and enablers to accessing these services were investigated. This was informed by a scoping review of the literature and a historic literature library.FindingsAdults with a learning disability are 10 times more likely than other adults to have a serious sight problem and children with learning disabilities are 28 times more likely. There is good evidence of high levels of unmet eye care need special schools in England with over 4 in 10 children attending having no history of any eye care.ConclusionThe authors discuss possible systemic changes to address these inequalities in England. These include automatic entitlement to an NHS sight test annually, specialist pathways in community opticians, eye care services in special schools, and peer to peer and peer to professional promotion of services by people with lived experience. Dedicated care pathways have improved uptake of services in other areas of primary care. Research into the effectiveness of lived experience eye health advocacy is needed. People with learning disabilities are much more likely to have sight problems but much less likely to get the eye care they need. Everyone should be able to access good eye care. Not getting good eye care puts eyesight at risk and existing problems might not be discovered. We look at what helps people get better eye care and what stops people from getting it. We found that improving awareness, better staff training and good communication are important. Special eye care services for people with learning disabilities have been designed but are not available in much of the UK. Having these specialist services across nations would help more people get the eye care they need.