Reporting for the National Disability Insurance Scheme: incorporating the functional impact of vision impairment

The Commonwealth of Australia has recently adopted a new innovative system of supporting people with disability; the National Disability Insurance Scheme (NDIS). Its objectives are grounded in a disability rights framework that endeavours to support people with permanent and significant disability in improved independence, community involvement, education, employment, health and well-being. To align with NDIS objectives, a major shift in perspective has occurred that moves disability service provision from a traditional funding scheme based entirely on the presence of a health condition, to one focussed on the functional impact of the person's health condition. However, despite this new approach, the capacity of a person with vision impairment to meet NDIS eligibility criteria for funding will not be judged by measures that indicate the functional impact of their vision impairment. Rather, the person's clinical measurements such as visual acuity and visual fields will be applied to predetermined criteria that have been deemed as suitable indicators of vision impairment.
This paper examined the existing professional literature that questions the application of clinical measurements to determine the functional impact of a person's vision impairment. Several models that recognise vision as a more complex entity were discussed. It is suggested that a broader approach to the assessment of a person's vision inclusive of both the clinical and functional domains, will assist ophthalmic reporting to more closely align with NDIS objectives, to enhance the support of Australians with vision impairment.