Abstract
BackgroundPrevention of visual impairment is an international priority agreed at the World Health Assembly of 2002- yet many countries lack contemporary data about incidence and causes from which priorities for prevention, treatment and management can be identified.MethodsRegistration as blind or partially-sighted in England and Wales is voluntary and is initiated by certification by a consultant ophthalmologist. From all certificates completed during the year April 1999 to March 2000, the main cause of visual loss was ascertained where possible and here we present information on the leading causes observed and comment on changes in the three leading causes since the last analysis conducted for 1990–1991 data.Results13788 people were certified as blind, 19107 were certified as partially sighted. The majority of certifications were in the older age groups. The most commonly recorded main cause of certifications for both blindness (57.2 %) and partial sight (56 %) was degeneration of the macula and posterior pole which largely comprises age-related macular degeneration. Glaucoma and diabetic retinopathy were the next most commonly recorded main causes. Overall, the age specific incidence of all three leading causes has increased since 1990–1991 – with changes in diabetic retinopathy being the most marked – particularly in the over 65's where figures have more than doubled.ConclusionThe numbers of individuals per 100,000 population being certified blind or partially sighted due to the three leading causes – AMD, diabetic retinopathy and glaucoma have increased since 1990. This may to some extent be explained by improved ascertainment. The process of registration for severe visual impairment in England and Wales is currently undergoing review. Efforts must be made to ensure that routine collection of data on causes of severe visual impairment is continued, particularly in this age of improved technology, to allow such trends to be monitored and changes in policy to be informed.
Highlights
Prevention of visual impairment is an international priority agreed at the World Health Assembly of 2002- yet many countries lack contemporary data about incidence and causes from which priorities for prevention, treatment and management can be identified
The majority of the certifications were in the older age groups; 83 % of the blind and 82 % of the partial sight certificates were completed for people aged 65 years and above
A similar pattern was seen with partial sight – between the ages of 0–64, 51 % of partial certifications were for males but after the age of 65 67 % of partial sight certifications were for females
Summary
Prevention of visual impairment is an international priority agreed at the World Health Assembly of 2002- yet many countries lack contemporary data about incidence and causes from which priorities for prevention, treatment and management can be identified. From the mid 1930's designated forms (BD8) signed by ophthalmologists were required in order to certify someone as blind or visually impaired. Part 5 was an anonymous epidemiological return containing data on the cause of visual impairment, which was sent to the Office of Population Censuses and Surveys (OPCS) { known as the Office of National Statistics (ONS)}. We present findings from an analysis of all BD8 part 5's completed during the year April 1999–March 2000 and compare these with results form the 1991 analysis
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