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124
In any welfare service purporting to be comprehensive or with
any aspiration to prevention, it is essential that skilled social
workers engaged in providing support for the blind should forge
the closest association with the family doctor and with the
specialist ophthalmological services.
The care of the eyes must begin at birth and methods of
testing sight and detecting defects must be so organized that
deviations from normal can be recognized and treated at the
earliest possible moment. This inevitably brings in the midwifery
service, the infant welfare clinics and the school health service and,
at the other end of the age structure, the domiciliary services for
the elderly. A department organized merely to provide help and
support for the already established blind is only providing half a
service and efforts must be made to bring the local ophthalmologists
more closely into consultation when decisions are taken as to the
best ways of dealing with particular cases. The possibilities and
advantages to be gained from vision screening on a community
basis must be explored. Results from such services to date have
been somewhat disappointing and have been incommensurate with
the effort and expense involved. It is much more important for the
ophthalmological services, whether provided by the family doctor,
the local authority or the hospital, to be working in harmony and
for a free exchange of information to flow between them.
Undoubtedly a substantial amount of blindness could be reduced
by ensuring the detection of potentially serious conditions before
irreversible deterioration has occurred. That is why it is so
important that workers engaged in welfare for the blind become
part of the whole organization and why they should be welcomed as
specialists in their own right. These are the future aims of the
department.
Registers—Registers of blind and partially sighted persons are
maintained. New cases which come into notice are referred from
many sources including the National Assistance Board, general
practitioners and hospitals. Subject to the consent of the person
concerned, an examination by a Consultant Ophthalmologist is
arranged. For this purpose the Council employs a part-time
ophthalmologist and examinations are arranged either by a
domiciliary visit or by transporting the patient to the departmental
Medical Examination Room. At appropriate intervals, similar
arrangements are made for re-examination of persons already on
the partially sighted register. Registration marks the point at which
case work service begins.