title: The challenges of providing eye care for adults with intellectual disabilities.
abstract: This review is intended to raise awareness of the importance of providing high-quality eye care for people with intellectual disabilities and the increasing need for this eye care to be community-based. We describe the challenges to the provision of high-quality community-based eye care for people with intellectual disabilities and ideas, evidence and methods for overcoming them. The prevalence of visual impairment in people with intellectual disabilities has been reported to be at least 40 per cent, rising to as high as 100 per cent in those with profound and severe disabilities. A progressive move toward deinstitutionalisation has shifted the provision of care for people with intellectual disabilities. Individuals can have the freedom to access health-care services of their choice. This has posed challenges to the health-care system, including how to deliver high-quality community-based eye care, creating a current significant unmet need for eye-care services. Undiagnosed refractive error and under-prescription of spectacles are major reasons for avoidable visual impairment among people with disabilities. There is an apparent reluctance of optometrists to engage in this work due to the perceived difficulties of working with people with intellectual and multiple disabilities. There are challenges associated with diagnosis and management of ocular conditions in people with intellectual disabilities and the demand is clear. Small shifts in training, knowledge and awareness would place optometry well to meet the challenges of this specialised area of eye care.
authors.affiliation: National Vision Research Institute, Australian College of Optometry, Carlton, Australia.
authors.forename: Josephine Ch
authors.initials: JCh
authors.lastname: Li
authors.affiliation: National Vision Research Institute, Australian College of Optometry, Carlton, Australia.
authors.forename: Katrina
authors.initials: K
authors.lastname: Wong
authors.affiliation: National Vision Research Institute, Australian College of Optometry, Carlton, Australia.
authors.forename: Adela Sy
authors.initials: AS
authors.lastname: Park
authors.affiliation: National Vision Research Institute, Australian College of Optometry, Carlton, Australia.|Brien Holden Vision Institute, Australia.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Fricke
authors.affiliation: Brien Holden Vision Institute, Australia.|Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia.|Royal Group of Hospitals, Northern Ireland, United Kingdom.
authors.forename: A Jonathan
authors.initials: AJ
authors.lastname: Jackson
mesh_terms: D000328:Adult; D003695:Delivery of Health Care / Q000639:trends*; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005128:Eye Diseases / Q000150:complications / Q000534:rehabilitation*; D006801:Humans; D008607:Intellectual Disability / Q000150:complications / Q000534:rehabilitation*; D009907:Optometry / Q000379:methods*
keywords: Down syndrome; autism spectrum disorder; cerebral palsy; deinstitutionalisation; intellectual disability; ocular manifestations; refractive error correction