I admit to having a finite amount of tolerance; it is sorely tested by selfish behavior, television talent shows – and the last album by Daft Punk. But I would certainly be able to sit quietly through a series of eye examinations. Alas, that’s something that not everyone – those with learning disabilities being one example – can manage. If a person with a learning disability has used up their five minutes of tolerance and becomes uncooperative, then an ophthalmologist might view them as a poor surgical candidate. This doesn’t have to be the case. All it takes is a little thoughtfulness and some forward planning to ensure that such people are not further disadvantaged by receiving sub-standard medical care.
Rachel Pilling’s article ("Serving Patients who have Learning Disabilities") addressing this issue can’t help but evoke a strong reaction. Amongst other things, she describes the incredible impact that good ophthalmology treatment can have on the quality of life of people with learning disability. For most patients, cataract removal is like “pulling the wool from their eyes” – it provides a significant improvement in vision that impacts not only quality of life but life expectancy too. Household tasks become easier, accidents fewer: life is just better. For patients – particularly children – with disability, the stakes are higher still, as improved vision means a greater ability to self-care. One practical impact is a reduction in dependence on carers, but the real gain from basic life skills improvement is the soaring dignity and self-esteem that it engenders in the patients. Restored vision also reopens educational opportunities, raising the question of how much learning impairment is actually due to clouded crystalline lenses. Elsewhere in this issue ("ACK-CXL For All"), Farhad Hafezi describes how one therapy, PACK-CXL, has the potential to revolutionize the treatment of infectious keratitis. Again, we can see thoughtfulness at work. Currently PACK-CXL needs to be performed by bulky equipment in sterile operating theaters. This is a treatment that kills almost all bacteria and fungi present in a matter of minutes. By developing a small, portable, and relatively inexpensive device that can safely do the job, Hafezi’s team have opened up the treatment to – including, crucially, many in developing countries, where the need is high, specialist eyecare is rare, and antibiotic-resistant organisms are rife. That’s two, small, thoughtful changes that really will make the world a better place. Now, if only other motorists were as thoughtful as our contributors, commuting would be much easier…
