• Best corrected visual acuity worse than 6/18 but better than or equal to 3/60 in the better eye.
• Or marked visual field reduction, even if central acuity is better than 3/60 (e.g., advanced glaucoma).
• Best corrected visual acuity worse than 3/60 in the better eye.
• Or visual acuity better than 3/60 but with severe visual field constriction (e.g., tunnel vision less than 10°), making functional vision extremely poor.
Certification Process
• Ophthalmologist-led assessment and decision.
• Completion of Certificate of Vision Impairment (CVI).
• Shared with patient, GP, and local authority.
Support and Benefits
• Registration enables access to social care services, rehabilitation, mobility training.
• Financial benefits:
o Disability Living Allowance (DLA) or Personal Independence Payment (PIP).
o Blind person’s personal income tax allowance.
o Travel concessions (free or discounted travel passes).
Low Vision Aids
• Magnifiers
• High-contrast and large-print materials
• Electronic reading aids
• Enhanced lighting recommendations
Common Causes of Visual Impairment
• Age-related macular degeneration (ARMD) — most common in elderly
• Glaucoma
• Diabetic retinopathy
• Cataract
• Inherited retinal dystrophies (e.g., retinitis pigmentosa)
Extra Revision Pearls
• <6/18 clue → eligible for sight impairment certification
• <3/60 clue → severe sight impairment (blindness)
• Severe field loss clue → may qualify as blind even if acuity better than 3/60
• ARMD clue → most common cause of certifiable visual loss in UK elderly
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Author & Educational Disclaimer
Author:
Dr Phillip Cockrell BM FRCP DipClinEd
Dr Phillip Cockrell is a UK Consultant Physician in Internal Medicine, currently working at Queen Alexandra Hospital, Portsmouth University Hospitals NHS Trust. He has previously worked as a registrar across Intensive Care Medicine, Gastroenterology, Cardiology, Stroke Medicine, Acute Medicine, and Respiratory Medicine.
He has held senior leadership roles including Associate Clinical Director of the Acute Medical Unit, Clinical Director of Internal Medicine, and Chief of Medicine. Dr Cockrell has over 15 years’ experience in postgraduate medical education, having lectured extensively across the MRCP syllabus and contributed to MRCP revision teaching and course development.
Dr Cockrell holds a Bachelor of Medicine (BM), Fellowship of the Royal College of Physicians (FRCP), and a Diploma in Clinical Education (DipClinEd). His teaching approach is based on structured consolidation of complex medical topics to support efficient and effective revision for postgraduate examinations.
Purpose of this content:
The material on this page is intended solely for educational purposes to support revision for the MRCP (UK) Part 1 examination. It reflects examination-relevant principles of internal medicine and is designed to aid learning and pattern recognition.
Medical disclaimer:
This content is designed for postgraduate medical examination revision and does not constitute medical advice, diagnosis, or treatment guidance and must not be used as a substitute for professional clinical judgement, local guidelines, or specialist consultation. Clinical decisions should always be made in the context of individual patient circumstances and current national guidance.
