Assessing presenting vision is practicable in field situations, but when a person presents for disability certification, every attempt should be made to improve vision before certifying.
However, while the NPCB definitions use presenting vision, we recommend best-corrected visual acuity (BCVA).
There are nine possible grades of disability based on the NPCB classification of normal vision (20/20 to 20/60), low vision (<20/60 to 20/200), economic blindness (<20/200 to 20/400) and social blindness (<20/400). The new classification suggested by us includes all combinations of vision in the two eyes. This means that a person with 25% neurological and 20% visual disability would have a combined disability of 40%, thus entitling him to benefits and concessions. The disability with the lower score (b) is added to the highest score (a) and final disability is calculated using the formula: There is a provision to combine the effects of multiple disabilities, particularly those involving neurological and musculoskeletal systems. On the other hand, in multiple disabilities, even a relatively small visual disability could make a difference in the final certification. In this respect, certification of one-eyed persons might be considered a wasteful exercise, causing unnecessary expenditure of resources in the certification process. They contend that clubbing one-eyed persons with other visual handicap categories will dilute the benefit to the latter. This occurs in spite of the Ministry of Health's notification that a person with <40% disability will not be eligible for benefits/concessions. However, even one-eyed persons (30% disability) request certification. Most persons seeking visual disability certification in this institution do so for severe disability (75-100% category). Finally, a classification was created using the national program for control of blindness (NPCB) definitions of normal vision, low vision, and blindness, and including every possible combination of vision in the two eyes of a visually disabled patient. The disability percentage recorded by the board was compared with the current classification, in order to determine the extent and type of disparity, if any.
Data were handled in accordance with the ethical standards of the Helsinki Declaration of 1975, as revised in 2000.
#Visual lighting calculation serial#
To protect anonymity, the names of patients were not noted we identified them by serial numbers. Data relating to vision in both eyes and the disability percentage accorded by the disability board was retrieved and entered into an MS Excel worksheet. In addition, the last hundred records of patients who had been classified as visually disabled in this hospital were screened. The current classification of visual disability was critically examined to determine which combinations of vision did not find a place in the classification.