Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 7 Sept 2026Clinical review pending
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Address immediate loss and unmet safety needs
A person being considered for certification can still develop a treatable eye emergency. Sudden loss or severe pain needs urgent clinical assessment; inability to obtain food, manage medicines or move safely may require immediate practical support.
Action: Separate any new ocular deterioration from longstanding impairment and use the emergency eye pathway when indicated. Assess immediate home and safeguarding needs, involve the appropriate support team with the person, and do not wait for certification paperwork before arranging necessary help.
Synopsis
Recognise when certification should be considered in England, distinguish it from voluntary registration, and organise timely practical, emotional and educational support for people with sight loss.
The DHSC CVI documents described here apply to England; other UK nations have their own forms and arrangements.
A consultant ophthalmologist certifies sight impairment or severe sight impairment using clinical judgement.
Acuity and visual field loss must be considered together, with their effect on everyday function.
Key red flags
Sudden visual deterioration is being attributed to an already known chronic eye condition.
Investigation priorities
01
Best-corrected acuity and visual field assessmentFirst step
Provide clinical evidence for the consultant's certification judgement.
Management branches
Considering certificationDiscuss eligibility and meaning with the patient
Visual impairment affects everyday function and certification may be appropriate.
Ask about current difficulties, treatment status and the person's understanding of certification.
Arrange consultant ophthalmology assessment using best-corrected acuity, fields, diagnosis and functional information.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.