Bradford eye box to assess vision of patients with learning difficulties unveiled nationally

Bradford eye specialists have achieved a national ‘first’ by developing a pioneering device that helps assess the sight of adults and children with complex and severe learning difficulties.


The Bradford Visual Function Box (BVFB) launches across England today (Nov 5) nationwide on November 5 and was created by Bradford Teaching Hospitals NHS Foundation Trust Paediatric Ophthalmologist, Professor of Special Needs and Learning Disability Eye Care, Rachel Pilling and Advanced Orthoptist, Caroline Rawse.


The BVFB contains a selection of small toys, beads, as well as black and white books, varying in size and colour, which are presented to the patient. Clinicians then make a visual assessment depending on observations and cues from the patient as the object approaches, including blinking, the pupils constricting, the eyes moving, smiling or vocalising and reaching out for the object.


Professor Pilling explained: “Adults with learning disabilities are 10 times more likely to have serious vision problems and for children this figure rises to 28 times more likely.


“Our experience of testing children and adults with complex needs is that it is difficult to engage them in traditional sight tests as they simply aren’t interesting enough or the largest size pictures big enough for some people to see. This sometimes meant they couldn’t access treatments or support.


“So about 10 years ago, here in Bradford, we started using a series of items to work out what size object people could see and at what distance, to help us to understand where in the person’s visual field they found it easiest to spot an object.”


Over the last decade, the box’s contents have been fine-tuned and its development supported by the Trust’s Bradford Innovations Group (BIG) which aims to turn good ideas into reality.


Late last year, the Trust awarded the licence for manufacture and sales to SeeAbility, a charity working with people with learning disability, autism and sight loss ( of which Professor Pilling is a trustee.


Ms Rawse said: “We believe that if we want to help people who have difficulty seeing, we must first be able to understand their functional vison – this is what they see, where they see and how they see it.


“The BVFB was more than a decade in the making and is simple, quick, portable and adaptable for use with children and adults with a wide range of abilities.


“It’s an innovative approach that means someone doesn’t need to be able to actively engage or communicate, but their eyesight can still be tested.


“It’s important to remember that no-one is too disabled to have an eye test though.”

Matt Broom, Strategic Lead for Eye Health and Vision at SeeAbility, said: “We are so pleased to be launching this fabulous eyecare tool and hope it will make a really positive difference to the eye care of adults and children with complex and severe learning disabilities.


“It’s easy to use, offers both clinician and patient/carer a more rewarding experience and works toward what we have always said at SeeAbility – that no one is too disabled to have an eye test.


“Whether it’s living, thriving, belonging or loving, ultimately what we want is greater inclusion and being able to make the best use of your vision is key to this. We look forward to the Bradford Visual Function Box being used across the county and beyond.”


Eye care professionals can use the BVFB results to explain what the person is able to see around them, which allows parents and support staff to instantly ‘see what they see’.


The box also enables families, support teams, medical professions and teachers to have a clear understanding of an individual’s vision which will lead to better support.


Bradford Teaching Hospitals’ Chief Executive, Professor Mel Pickup, added: “I’m delighted to hear that the BVFB has been included in the equipment list for the NHS England Special School Eye Care Service, a national programme to ensure every child with special needs has a sight test every year.


“I sincerely hope that the BVFB will lead to adults and children with learning difficulties having access to better treatments and support.”