Objective: To study recent trends in the cumulative incidence of visual impairment in childhood over a 15-year period and to assess progress against WHO goals for prevention.
Design, setting and participants: Data from a population-based register of visual impairment in southern England were used to estimate cumulative incidence and trends in visual impairment (VI) and severe visual impairment/blindness (SVI/BL) for children born in 1984–1998. Causes were classified by anatomical site(s), timing of insult(s) and whether the visual impairment was 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 12 years was 7.1 (95% CI 6.4 to 7.8) per 10 000 live births and for SVI/BL was 6.2 (95% CI 5.6 to 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% of children with VI and 77% with SVI/BL had other impairments; the proportion of associated impairments among children with VI decreased over time. 130 (19%) of the children have died, with over half dying before the age of 5.
Conclusions: There is evidence of a temporal decline in the incidence of VI and SVI/BL in births from 1984 to 1998 especially in very preterm and low birthweight infants. Early childhood mortality was high. The causes of visual impairment in UK children are numerous, complex and often part of a wider picture of childhood disability.
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Funding: This work was carried out at the National Perinatal Epidemiology Unit which is funded by a grant from the Department of Health, England. 4Child is funded by the Department of Health Policy Research Programme under the Research Active Disease Registers Funding Initiative. JJ Kurinczuk was partially funded by a National Public Health Career Scientist Award from the Department of Health NCC RCD (PHCS02). F Bodeau-Livinec was funded by the French Ministry of Foreign Affairs, the French Society of Perinatal Medicine and GlaxoSmithKline. The various funding sources had no involvement in the design or conduct of any stage of this work, or in the decision to submit for publication. The views expressed in this paper are those of the authors and not necessarily those of the Department of Health.
Competing interests: None.
- Office for National Statistics
- severe visual impairment/blindness
- visual impairment