VISPA Takes First Step in Planning for the Eyes of the Future.
The Vision Impaired Service Providers Alliance’s (VISPA) inaugural Conference was held at St. Joseph’s School for the Visually Impaired on October 9th 2008, World Sight Day. The main focus of the conference was the launch of a new study into the prevalence of blindness and vision impairment in Ireland entitled “Eyes on the Future”. This was supplemented by ‘an overview on the five main eye conditions’ by Dr. Giuliana Sylvestri of the Royal Victoria Hospital, Belfast.
Other speakers at the conference were: Peter Wakefield, senior lecturer on special education, University of Worcester, who spoke on future training needs for professionals in the field of education of the visually impaired, Michael Bruton, consultant to the Department of Health and the HSE, who spoke on the development of service provision for an aging population, Dr. John Nolan, Waterford Institute of Technology who spoke on longevity and vision impairment and Dr. Arthur O’Reilly, board member of Irish Guide Dogs for the Blind, who spoke on an holistic approach to the provision of mobility training for blind and vision impaired people.
VISPA enlisted the expertise of Professor Jonathan Jackson, Royal Victoria Hospital and Queen’s University Belfast, and Professor Colm O’Brien, Mater Misericordiae University Hospital Dublin, to lead the first stages of its study (Co-authors were Ms Bláithín Gallagher (NCBI), Mr Eoin Dardis (NCBI), Dr. R, Sugrue and Dr. M. Codd (UCD). The authors of the “Eyes on the Future” report examined the results of leading epidemiological studies from across the developed world.
Historically there has been a woeful lack of proper statistics on blindness and vision impairment in Ireland. Apart from NCBI’s work in the compilation of its blind register, there was no real knowledge-based means to realistically project the true extent of blindness and vision impairment in Ireland and to plan services into the future.
While there are more than 13,000 people known to NCBI to be blind or vision impaired, approximately two-thirds of these meet the criteria of being legally blind. The remainder, while not legally blind, have significantly low vision to require rehabilitation services and support to assist them in living with sight loss. It is known that this figure underestimates the overall numbers by approximately 30%.
The report reveals that of 138 publications referring to blindness or vision impairment in Ireland, less than six make specific reference to the overall prevalence of impaired sight on the island. Of those papers which do, virtually all draw specifically from data held on the respective blind registers in both the Republic of Ireland and Northern Ireland.
The NCBI sponsored Kelliher review of the register in 2003, highlighted that numbers on the register had increased by 37% since 1996. The current overall prevalence rate runs at 0.22% and, of those newly registered, 40% are 80 years old or older. The main causes for registration are age related macular degeneration (25%), glaucoma (12%), cataract (11%), retinitis pigmentosa (7%), myopic degeneration (5%) and diabetic retinopathy (5%). When compared with earlier data gleaned from a review of the register in 1996, there appears to have been a 113% increase in age related macular degeneration and a 120% increase in diabetic retinopathy.
Comparative data gathered in Northern Ireland indicated a higher overall prevalence of registration (0.35%). The three main causes were age related macular degeneration, glaucoma and diabetic retinopathy. Diabetic retinopathy ranked higher, as a cause of vision impairment, than in the Republic of Ireland.
The report states that it is “now universally agreed that data obtained specifically from national registers of blindness and vision impairment significantly underestimates the true prevalence of vision impairment in general and of low vision in particular”.
As there are many different criteria used throughout the world for the registration of blindness, the current report looked at data published in five studies which had been presented in such a way that estimates could be calculated using World Health Organisation (WHO) criterion (of a visual acuity of less than 3/60), to establish the current prevalence of blindness and vision impairment in Ireland.
From these, it can be extrapolated that it is likely that there are some 4,000 persons aged 55 years and over currently blind in Ireland. Estimates of vision impairment differ significantly (visual acuity of less than 6/18 – 3/60) from study to study, but based on the findings of a relatively conservative study conducted in Rotterdam, it is likely that there are more than 11,000 people who meet the WHO criterion for vision impairment.
The figure calculated using data from a study conducted in Melbourne would be almost double that of Rotterdam (24,000). Using data from other studies as a comparison, the figures would be much higher. The prevalence of vision impairment in those 50 years old and over as defined by a visual acuity of less than 6/12 (that deemed necessary for driving) would rise to a staggering 8.4% (96,000). Following refraction and the provision of appropriate spectacles this figure would be expected to drop to 6.7% (77,000).
The launch of the “Eyes on the Future” report marks a first step in VISPA’s aim to get a more accurate picture of the potential prevalence of sight loss in Ireland. The results will enable VISPA in its discussions with government and the Health Service Executive (HSE) and empower it as it lobbies for adequate provision of funding for services and additional investment in eye health care.
To that end VISPA will be pressing for a full epidemiological ophthalmic study that builds on this report’s findings and recommendations.
The full report is available on the NCBI website at www.ncbi.ie