Is there evidence that the yearly numbers of children newly certified with sight impairment in England and Wales has increased between 1999/2000 and 2014/2015? A cross-sectional study

Abstract

ObjectivesTo use routine data capture from hospitals in England and Wales to identify whether there has been an increase in the annual numbers of children newly certified sight impaired in England and Wales between 1999/2000 and 2014/2015 and to examine causes of certifiable sight impairment in children certified in 2014/2015.DesignA cross-sectional study including an analysis of all certificates of vision impairment completed in hospitals in England and Wales each year between 2007/2008 and 2014/2015 and all certificates completed in hospitals in England and Wales in 1999/2000.ParticipantsCertificates for all individuals aged 16 years or less at the time of certification in England and Wales for each financial year between 1 April 2007 and the 31 March 2015 and for individuals aged 15 years or less for the year ending 31 March 2000. We obtained information on the main cause of certifiable sight loss for all children certified in 2014/2015. We estimated crude and sex specific incidence estimates with 95% confidence intervals computed by Byars method.ResultsIn 1999/2000, the estimated incidence (95 % CI) of certification was 8.2 (7.7 to 8.8) per 1 00 000. In 2007/2008, the estimated incidence was statistically significantly higher at 10.1 (9.5 to 10.7). Since then a trend of increasing incidence with time has been observed until 2014/2015 when an estimated incidence of 13.3 (12.6 to 14.0) was observed. Hereditary retinal dystrophies, cerebral visual impairment and nystagmus were the most common single causes of certifiable sight impairment in children in 2014/2015.ConclusionOur findings show that in England and Wales there has been an increase in the number of children newly certified sight impaired by consultant ophthalmologists since 1999/2000. This mirrors our previous findings based on data originating within social service departments.

Temporal trends in the epidemiology of childhood severe visual impairment and blindness in the UK

“…Whilst certification of sight impairment exists and for adults serves as a means of referral to governmental financial support, social care and specialist education provision, it is not statutory, entails limited collection of data, employs criteria different to the WHO international taxonomy and is not always coincident with diagnosis, making the system unsuitable for detailed epidemiological research. Additionally as the resulting data are sensitive to procedural changes, [14] it is challenging to interpret certification rates as a reflection of incidence alone. Thus the main strengths of our study are the utilisation of two nationally representative studies of clinician-confirmed cohorts of children newly diagnosed with SVI/BL with identical methods of case ascertainment and structured detailed data collection.…”

Recent trends in vision impairment certifications in England and Wales

“…Since then a trend of increasing incidence has been observed until 2014/2015 when the estimated incidence was 13.3 (12.6-14.0). Hereditary retinal dystrophies, cerebral visual impairment and nystagmus were the most common causes of certifiable sight impairment in children in 2014/2015 [15].…”

Oral levodopa rescues retinal morphology and visual function in a murine model of human albinism

“…Consequently, the majority of children with albinism are registered as sight impaired in the UK (Certificate of Visual Impairment, CVI) and require significant, lifelong visual support. Accordingly, albinism is the third most common cause for CVI registration in children in the UK (Bunce, Zekite, Wormald, & Bowman, ) and this is mirrored worldwide. Albinism also has significant effects on school performance, employment and quality of life, and carries a negative stigma especially in people of Southeast Asian and African descent (Kiprono, Joseph, Naafs, & Chaula, ; Maia, Volpini, dos Santos, & Rujula, ).…”