In this article the authors present an epidemiological update, based on certifiable visual impairment (CVI) registration for figures for sight impairment (SI) in England and Wales from the last report of 2007-2008 to the current data for April 2012 to March 2013. A proportional comparison between the two sets of data is made. A total of 24,009 completed CVIs were received during this period; 10,410 were for severe sight impairment (SSI) and 13,129 were for SI. These numbers were slightly higher than April 2007 – March 2008 (9823 SSI; 12,607 SI). The ratio between SI:SSI, however, remained static, with 55% of certifications being SI. The proportion of certificates without a single main cause has fallen slightly (16.6 to 14%). The most commonly recorded cause of SSI was degeneration of the macula and posterior pole (mainly age-related macular degeneration (AMD)). This, however, decreased from 58.6 to 50% SSI and from 57.2 to 52.5% SI. This may reflect the increasing availability of anti-VEGFs. Glaucoma remains the second most common cause (11% SSI; 7.6% SI). The figures from glaucoma registration rose from 8.4 in 2007-2008 to 11% in 2012-2013. Hereditary retinal disorders ranked as the third leading cause of SSI certifications (8.2%). It superseded diabetes which is now responsible for 5.4% of SSI registrations. This likely reflects better screening and treatments. Optic atrophy (4.9%), cerebrovascular disease (2.7%), disorders of the visual cortex (2.6%) and retinal vascular occlusions (2%) were the next in frequency for SSI certification. AMD still remains the leading cause of certifications for sight impairment in England and Wales (both SI and SSI). It is understood that although CVI registration may be a life changing event, it initiates a process with the local Social Services department that entitles individuals to a range of support, including concessions, loan of aids and equipment which may substantially help to improve their quality of life. 

Leading causes of certifiable visual loss in England and Wales during the year ending 31 March 2013.
Quartilho A, Simkiss P, Zekite A, et al.
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Sofia Rokerya

MBBS MRCOphth FRCSI, King's College University Hospital, UK.

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