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Diabetes ‘no longer leading cause of blindness’ in the UK

Figures showing that for the first time in more than half a century diabetic eye disease is no longer the leading cause of blindness in adults of working age have been welcomed by health authorities.
Public Health England says the fall can be partly attributed to better screening.
The figures are drawn from a study published in BMJ Open which examined the causes of blindness in people aged 16 to 64 living in England and Wales.
The study compared the number of people registered as blind in the year 2009 to 2010 with the same period 10 years earlier. This showed that inherited retinal disorders had overtaken diabetes as the main cause of blindness.
Changes over 10 years
Between 1st April 1999 and 31st March 2000 the 3 leading causes of blindness were:
• Diabetic retinopathy/maculopathy (17.7%)
• Inherited retinal disorders (15.8%)
• Optic atrophy (10.1%)
Between 1st April 2009 and 31st March 2010 the 3 leading causes of blindness were:
• Hereditary retinal disorders (20.2%)
• Diabetic retinopathy/maculopathy (14.4%)
• Optic atrophy (14.1%)
These figures are based on 1,756 registrations filed in 2009 to 2010 and 1,637 filed in 1999 to 2000.

Significant change
The research team, led by Moorfields Eye Hospital in London, say the figures represent a marked change in the main causes of blindness, as diabetes had been the main cause of blindness among working adults in England and Wales since at least 1963.
The authors say that falling rates of blindness caused by diabetes is significant because available data suggests that diabetes rates have risen over the last few decades. They conclude that a nationwide programme of eye checks for people with diabetes (diabetic retinopathy screening) introduced between 2003 and 2008 may be responsible for the fall.
However, the authors say these results are speculative and should be read with caution.
‘A key role’
Public Health England is more upbeat on the underlying factors and says screening has “played a key role”. In a statement, Dr Anne Mackie, director of programmes for the UK National Screening Committee, part of Public Health England, says: “Before the launch of the diabetic eye programme, less than half of the people with diabetes had regular eye screening. Even where they did, the quality of the test varied from one place to another and many developed serious eye problems that could have been prevented.
“2.5 million people are invited for diabetic retinopathy screening every year. Last year more than 74,000 were referred to hospital eye services for further investigation which led to around 4,600 people with diabetes receiving treatment to help prevent sight loss.”
‘More work needed’
Commenting on the study in a statement, Simon O’Neill, Diabetes UK director of health intelligence, says: “The fact that hereditary disorders are now the main cause of sight loss in the working age population is partly because these disorders are being better recognised and diagnosed, but it may also be partly because the Diabetic Eye Screening programme has played an important role in ensuring diabetes-related eye problems are being picked up earlier before they become sight threatening. This highlights why it is so important that everyone with diabetes gets an eye check at least once a year.
“But while this news is partly because of the good progress made in the last decade, it is important to emphasise that diabetes remains the leading cause of preventable sight loss in working age people and sadly every year there are still too many people with diabetes who are losing their sight unnecessarily. We know, for example, that many people are still not having their annual eye checks. Also, while the rate of blindness has reduced, the rising number of people with diabetes means the actual number of people with diabetes who lose their sight has stayed about the same so there is still much work that needs to be done.”

Source: WebMD
Research Source: BMJ Open