There are a number of issues which need to be raised when examining the impact of vision impairment on children's lives. In a pilot study, the problems raised predominantly by primary caregivers of children with mild to moderate vision impairments indicate that current health care practices still tend to be defined in narrow biomedical terms in this area. This is because the psychosocial impacts of these degrees of impairment are not adequately understood by families, health and other professionals and are therefore not effectively dealt with. This often creates a situation in which families are sent from one health service delivery domain to another with no one service taking responsibility for providing the needed assistance - often with parents taking on advocacy roles which in human terms produce extreme strain (Rees & Emerson, 1984).