A comparison of the causes of blindness certifications in England and Wales in working age adults (16-64 years), 1999-2000 with 2009-2010

Gerald Liew, Michel Michaelides, Catey Bunce, Gerald Liew, Michel Michaelides, Catey Bunce

Abstract

Objectives: To report on the causes of blindness certifications in England and Wales in working age adults (16-64 years) in 2009-2010; and to compare these with figures from 1999 to 2000.

Design: Analysis of the national database of blindness certificates of vision impairment (CVIs) received by the Certifications Office.

Setting and participants: Working age (16-64 years) population of England and Wales.

Main outcome measures: Number and cause of blindness certifications.

Results: The Certifications Office received 1756 CVIs for blindness from persons aged between 16 and 64 inclusive between 1 April 2009 and 31 March 2010. The main causes of blindness certifications were hereditary retinal disorders (354 certifications comprising 20.2% of the total), diabetic retinopathy/maculopathy (253 persons, 14.4%) and optic atrophy (248 persons, 14.1%). Together, these three leading causes accounted for almost 50% of all blindness certifications. Between 1 April 1999 and 31 March 2000, the leading causes of blindness certification were diabetic retinopathy/maculopathy (17.7%), hereditary retinal disorders (15.8%) and optic atrophy (10.1%).

Conclusions: For the first time in at least five decades, diabetic retinopathy/maculopathy is no longer the leading cause of certifiable blindness among working age adults in England and Wales, having been overtaken by inherited retinal disorders. This change may be related to factors including the introduction of nationwide diabetic retinopathy screening programmes in England and Wales and improved glycaemic control. Inherited retinal disease, now representing the commonest cause of certification in the working age population, has clinical and research implications, including with respect to the provision of care/resources in the NHS and the allocation of research funding.

Keywords: Public Health.

Figures

Figure 1
Figure 1
Main causes of severe sight impairment (blindness) in England and Wales in working age adults (age 16–64): certifications 2009–2010.
Figure 2
Figure 2
Ten-year change in causes of severe sight impairment (blindness) in England and Wales in working age adults (age 16–64): certifications 1999–2000 and 2009–2010.

References

    1. Sorsby A. The causes of blindness in England 1948-50. London, HMSO, 1953
    1. Sorsby A. The incidence and causes of blindness in England and Wales 1948-1962. 1–78. 1966. London, HM Stationery Office; Reports on Public Health and Medical Subjects No. 114
    1. Barry RJ, Murray PI. Unregistered visual impairment: is registration a failing system? Br J Ophthalmol 2005;89:995–8
    1. Robinson R, Deutsch J, Jones HS, et al. Unrecognised and unregistered visual impairment. Br J Ophthalmol 1994;78:736–40
    1. UK Department of Health Healthy lives, healthy people: improving outcomes and supporting transparency. 2012
    1. Bunce C, Wormald R. Causes of blind certifications in England and Wales: April 1999-March 2000. Eye 2008;22:905–11
    1. Bunce C, Wormald R. Leading causes of certification for blindness and partial sight in England & Wales. BMC Public Health 2006;6:58.
    1. Bunce C, Xing W, Wormald R. Causes of blind and partial sight certifications in England and Wales: April 2007-March 2008. Eye 2010;24:1692–9
    1. Sorsby A. The incidence and causes of blindness tn England and Wales 1963–1968. 1972. London: HM Stationary Office; DHSS reports on public health and medical subjects No 128
    1. Centers for Disease Control and Prevention. [2013 (cited 2013 Jul 20).
    1. Lusignan S, Sismanidis C, Carey IM, et al. Trends in the prevalence and management of diagnosed type 2 diabetes 1994-2001 in England and Wales. BMC Fam Pract 2005;6:13.
    1. Khunti K, Goyder E, Baker R. Collation and comparison of multi-practice audit data: prevalence and treatment of known diabetes mellitus. Br J Gen Pract 1999;49:375–9
    1. Holman N, Forouhi NG, Goyder E, et al. The Association of Public Health Observatories (APHO) Diabetes Prevalence Model: estimates of total diabetes prevalence for England, 2010-2030. Diabet Med 2011;28:575–82
    1. Forouhi NG, Merrick D, Goyder E, et al. Diabetes prevalence in England, 2001—estimates from an epidemiological model. Diabet Med 2006;23:189–97
    1. NHS Diabetic Eye Screening Programme. 2013. .
    1. Diabetic Retinopathy Screening Service Wales. 2013. .
    1. Calvert M, Shankar A, McManus RJ, et al. Effect of the quality and outcomes framework on diabetes care in the United Kingdom: retrospective cohort study. BMJ 2009;338:b1870.
    1. Campbell SM, Reeves D, Kontopantelis E, et al. Effects of pay for performance on the quality of primary care in England. N Engl J Med 2009;361:368–78
    1. Millett C, Saxena S, Ng A, et al. Socio-economic status, ethnicity and diabetes management: an analysis of time trends using the health survey for England. J Public Health (Oxf) 2007;29:413–19
    1. Oluwatowoju I, Abu E, Wild SH, et al. Improvements in glycaemic control and cholesterol concentrations associated with the Quality and Outcomes Framework: a regional 2-year audit of diabetes care in the UK. Diabet Med 2010;27:354–9

Source: PubMed

Patrocinadores e Colaboradores

Condições médicas

Intervenções de drogas

3
Se inscrever