Topic summary on people experiencing sight loss JSNA

The Royal National Institute of Blind People (RNIB) has calculated that there are over 10,000 people currently living with sight loss in Manchester. This is projected to increase due to the ageing of the population alongside a growth in the prevalence of conditions associated with poorer eye health, such as diabetes. Ophthalmology is the busiest outpatient specialty in England, with around 7.5 million ophthalmology outpatient attendances taking place in 2021/22. Estimates suggest that sight loss and blindness results in around £8.65 billion in direct and indirect health care system costs.

This JSNA looks at the issues experienced by people with sight loss through the lens of the Social Model of Disability. It focuses on the socially constructed barriers which disable and exclude people, rather than their impairments and, in doing so, moves the focus of attention away from a person’s impairments towards a better understanding of the barriers that people face when accessing services or support and what their communication requirements are. This will enable public services to identify and provide solutions to those barriers rather than focus on what a person is not able to do.

Sight loss, also known as visual impairment or vision loss, refers to a reduction in the ability to see that cannot be corrected using standard treatments such as glasses, contact lenses, medication or surgery. It can range from mild vision difficulties to complete blindness and may include blurred vision, reduced peripheral (side) vision, central vision loss, low vision or a difficulty distinguishing colours. Sight loss may affect one or both eyes and can be either partial - where some vision remains - or total, with no light perception at all. Many children with sight loss can experience it from birth, although it may occur later in life after an illness or injury, or because of a medical condition. However, most visual impairments will affect a child throughout their life.

This JSNA provides a summary of the evidence and data regarding the needs of people experiencing sight loss. It summarises what we know about the causes of sight loss and the number and characteristics of people that are affected by it in Manchester. It also describes what Manchester City Council, the NHS and other VCFSE sector organisations working in the city are doing to support people experiencing sight loss, the current gaps in the funding and provision of services for this group of people and some of the opportunities for action that exist to address these gaps.

Key points highlighted in the JSNA include:

• Adults with sight loss are around five times more likely to have ‘bad’ or ‘very bad’ general health compared with adults with no sight loss. People with sight loss are also up to three times more likely to report low life satisfaction and psychological distress. Diabetes and high blood pressure are more prevalent among people with sight loss, which may further exacerbate eye health issues. Sight loss is also associated with an increased risk of dementia and other cognitive impairments, due to reduced sensory input and lower engagement in stimulating activities.
  
• Impaired vision significantly increases the risk of accidents and reduced confidence in movement can lead to physical inactivity and a loss of independence. Disrupted circadian rhythms, particularly in people with total blindness, can lead to a range of sleep disorders such as insomnia and irregular sleep patterns. People with sight loss are also more likely to be prescribed multiple medications, increasing the risk of adverse drug interactions. Difficulties in reading labels or managing prescriptions can also result in medication errors, such as incorrect usage or missed doses.
  
• There are a number of key risk factors for sight loss, including age, deprivation and general health. Younger people from certain ethnic minority groups are at greater risk of some forms of sight loss but, overall, people from ethnic minority groups are no more likely to have sight loss compared to white people.
  
• Negative public attitudes towards sight loss can limit the independence and inclusion of blind and partially sighted people. More than a third of blind and partially sighted people say that they sometimes or frequently experience negative attitudes from the public due to their sight loss and four out of ten blind and partially sighted people report that they were unable to make all the journeys that they want or need to make because of these negative attitudes.
  
• Features of the built environment can place barriers in the way of enabling people experiencing sight loss to travel and move independently around their local area. People with visual impairments may also experience a range of barriers that prevent them from finding and staying in work.

The JSNA summarises the services commissioned or provided by Manchester City Council and its partners to support people with sight loss, including the Manchester Sensory Support Service (MSSS), the Manchester Local Care Organisation (MLCO) Sensory Team, the Highways Major Projects Team and the Manchester Travel Training Partnership (MTTP). It also describes the work of Manchester College in providing specialist support for Further Education students with a visual need as well as the work of other national and local VCFSE sector organisations that have a focus on supporting people with sight loss.

In terms of NHS services for people experiencing sight loss, the JSNA describes the role of NHS General Ophthalmic Services (GOS) in providing preventative and corrective eye care through community optician practices. It also describes some of the treatment and support services provided through the Manchester Royal Eye Hospital, including the Eye Clinic Liaison Officer (ECLO) service for children, adults and families.

As part of the work to develop this JSNA, the Department of Public Health has worked in partnership with VCFSE sector organisations and other local service providers to identify gaps in the funding and provision of services for people experiencing sight loss in Manchester. The authors have also engaged directly with people experiencing sight loss and other impairments through the Disabled People's Sounding Board. The opportunities for action included in the JSNA draw on the findings from both of these engagement mechanisms.

It is estimated that around 50% of sight loss is avoidable and action to prevent sight loss can be taken at all levels of the prevention spectrum. Early intervention is important in allowing people to develop social skills, maintain independence and cognitive ability and to prepare them for adulthood. It is important to ensure that actions to prevent people experiencing sight loss are considered as part of wider discussions around prevention and early intervention.

Other specific opportunities for action identified in the JSNA include:

• Improvements to service pathways and support for people with sight loss, including specialist vision loss community and residential support for people with vision loss.
• Improved support for children and young people with vision loss transitioning to Adults Services.
• Improvements to digital health platforms and systems accessed by people experiencing sight loss.
• Regular accessibility audits of health and social care premises, focusing on visual access.
• Exploring ways of making it easier for people with diabetes to receive vision health care in places and times that suit them.

The JSNA also highlights the risk associated with the lack of sustainable, long-term sources of funding for services to support people experiencing sight loss in Manchester.

This JSNA was completed in October 2025 and was presented to the Health and Wellbeing Board on the 19 November 2025.

A full copy of the JSNA can be accessed as part of the papers for that meeting.