Unregistered visual impairment: is registration a failing system?
OBJECTIVE
To assess the current level of under-registration of blindness and partial sight among patients attending a large teaching hospital, and to determine any risk factors for under-registration.


METHODS
Medical records of all patients attending general ophthalmology outpatient clinics over a 3 month period were included in a retrospective analysis of registration rates; questionnaire survey assessing the level of knowledge of registration practices among 35 ophthalmologists working in the West Midlands.


RESULTS
146/2161 (7%) patients were eligible for blind or partial sight registration, or were in possession of a completed BD8 form. Of these 146 patients, 65 (45%) were unregistered with 18 fulfilling the criteria for blind and 47 for partially sight. In addition, 32/81 (40%) registered patients appeared to have been inappropriately registered. Partially sighted patients were more likely to be unregistered than blind patients (OR 2.31, 95% CI 1.15 to 4.63, p = 0187), and patients from ethnic minorities were more than three times more likely to be unregistered than white patients (OR 3.23, 95% CI 1.56 to 6.65, p = 0.0015). A patient with a treatable condition was more likely to be unregistered than a patient with an untreatable condition (OR 4.87, 95% CI 2.10 to 11.33, p = 0.0002). The overall level of knowledge of registration practices among doctors was found to be low and there was no indication of increasing knowledge with increasing experience.


CONCLUSIONS
There has been little improvement in registration rates of visually impaired patients over the past decade. Ophthalmologists lack the necessary knowledge to cater for visually impaired patients' needs.
Barry
R J
RJ
Academic Unit of Ophthalmology, Division of Immunity and Infection, University of Birmingham, Birmingham, UK.
Murray
P I
PI
D000293:Adolescent; D000328:Adult; D000368:Aged; D001766:Blindness / Q000453:epidemiology*; D002983:Clinical Competence; D004739:England / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000592:standards; D008875:Middle Aged; D009885:Ophthalmology / Q000592:standards; D010044:Outpatient Clinics, Hospital; D012042:Registries / Q000592:standards*; D012189:Retrospective Studies; D015354:Vision, Low / Q000453:epidemiology*