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Sight-related issues can impose several challenges for everyone, and it gets more complicated for people with disabilities or children with special needs.[1,2] Children with cerebral palsy, Down syndrome, and autism are some common examples of special needs conditions often accompanied by significant visual complications.[3,4] Comprehensive eye examinations for these children are essential, as they may be diagnosed with problems that can be treated to improve the child’s developmental milestones and ultimately their quality of life (QoL). The 2030 Agenda for Sustainable Development’s focal point of “Leave no one behind” is in sync with Mission for Vision’s (MFV) core value of “Services for all”. MFV works with leading eye hospitals across India to ensure that every single person has easy access to quality eye care and there is a special focus on “children with special needs (CSN)”.
MFV and RenewSys India Pvt. Ltd. joined hands to establish a Special Needs Vision Clinic (SNVC) in July 2018. CSN who require eye care benefit from this exclusive facility at the Institute for Vision Rehabilitation at LV Prasad Eye Institute (LVPEI), Hyderabad. The centre aims to provide comprehensive and customised eye care services for CSN by assessing their visual needs with special assessment tools, providing them with appropriate spectacle prescriptions, low vision devices, and therapies to maximise their functional ability and enhance their overall QoL and well-being.
The SNVC gets majority of its patients as referrals from in-house sub-specialty clinics, external organisations, and private hospitals. Children visit the clinic accompanied by their parent(s) and are offered an initial screening and evaluation. Based on the initial case diagnosis, the child-parent pair is introduced to various rehabilitative and support interventions that require several follow-up visits over time. Since its inception, a total of 11,414 children with special needs were referred for ophthalmic screening, of which 53.6% were given a baseline visual assessment and about 33% were seen periodically in the clinic for follow-up vision assessments. A total of 9,003 (79%) children went through early intervention assessment for developmental delays and were offered various follow-up sessions that included vision and low-vision rehabilitation, speech therapy, physiotherapy, special education, and Sanet Vision Integrator (SVI) to enhance eye-hand coordination. A total of 24 awareness sessions with parents and other stakeholders were organised covering several important aspects that are relevant to children with visual impairment (VI) and for those with delayed development.
COVID-19-induced lockdowns were a huge deterrent and the number of patients visiting the facility declined by about 50% during the fiscal year (FY) 2020-2021 as compared to the preceding FY. There was a significant change in the pattern of service delivery as the clinic had to adapt to the emerging COVID-19 scenario. In response to the lockdowns, the clinic staff came up with the following novel strategies to deliver uninterrupted services:
As the COVID-19 situation improved, the services were back to normal. Gradually, patients were encouraged to visit the clinic for subsequent follow-up therapies. Post-lockdown, the number of clients visiting the clinic improved, and the data indicated that during the FY 2021-2022, the number of patients visiting the clinic increased by 60% as compared to the COVID-19 lockdown year.
Vision rehabilitation (VR) is a new emerging sub-specialty that aims to improve the functionality and independence of patients with multiple disabilities using a multi-disciplinary approach.