Recent trends in visual impairment and blindness in the UK

Abstract

Objective:To study recent trends in the cumulative incidence of visual impairment in childhood over a 15 years period and to assess progress against WHO goals for prevention.

Design, setting and participants:Data from a population-based register of visual impairment in south England were used to estimate cumulative incidence and trends in visual impairment (VI) and severe visual impairment/blindness (SVI/BL) for children born 1984-1998. Causes were classified by anatomical site(s), timing of insult(s) and whether potentially preventable or treatable.

Results:Of 691 eligible children 358 (53%) had VI and 323 (47%) SVI/BL. The cumulative incidence of VI to age 12yrs was 7.1 (95%CI 6.4-7.8) per 10,000 live births and for SVI/BL was 6.2 (95%CI 5.6-6.9); the incidence of both decreased significantly over time. There was an inverse relationship with gestational age and birth weight, although the risk of visual impairment associated with prematurity and low birth weight decreased substantially over time. 55% with VI and 77% with SVI/BL had other impairments; the proportion of associated impairments among children with VI decreased over time. 19% (130) of the children have died with over half dying before age five.

Conclusions:There is evidence of a temporal decline in incidence of VI and SVI/BL in births 1984 to 1998 especially in very preterm and low birth weight infants. Early childhood mortality was high. The causes of visual impairment in UK children are numerous, complex and for many are part of a wider picture of childhood disability.