title: Changes in causes of low vision between 1988 and 2009 in a Dutch population of children.
abstract: OBJECTIVE
  Causes of low vision in the Netherlands may have changed over time. The purpose of this study is to assess trends over the last two decades.
  
  
  METHODS
  Socio-demographic and medical data, including ophthalmic diagnosis and inheritance patterns for 2843 children with low vision (0-21 years; 50% representation) referred to a Dutch institute for low vision (Bartiméus) over a 21-year period between 1988 and 2009, were included in the analysis. For the 19 most common diagnoses, inheritance and presence of mental impairment, trend analyses were performed with logistic regression models; odds ratios (OR) for a 10-year time span were reported.
  
  
  RESULTS
  Cerebral visual impairment (CVI) was found in 27.2% (97% mental impairment), albinism in 8.0%. Over time, nystagmus (6.6%; OR = 1.42), retinitis pigmentosa (2.9%; OR = 1.61), cone-rod dystrophy (2.6%; OR = 1.98) and hyperopia (2.0%; OR = 3.66) increased significantly. Cataract (4.9%; OR = 0.64), aniridia (1.6%; OR = 0.42) and retinopathy of prematurity (ROP; 2.0%; OR = 0.45) decreased significantly. There was a significant increase in genetic disorders (41.0%; OR = 1.49) and in co-occurrence of mental impairment (52.2% OR = 1.16).
  
  
  CONCLUSIONS
  In the last two decades, treatable or preventable disorders (such as cataract and ROP) have become a less common cause of low vision in children. However, the prevalence of complex (genetic) and untreatable disorders (CVI) has taken its place, as a result of increased survival of preterm and low birth weight children and improved diagnostic possibilities. Knowledge of the prevalence of low vision, its causes and trends over time may help policy makers to define effective intervention strategies and to monitor its impact.
authors.affiliation: Bartiméus Institute for the Visually Impaired, Zeist, The Netherlands. nboonstra@bartimeus.nl
authors.forename: Nienke
authors.initials: N
authors.lastname: Boonstra
authors.forename: Hans
authors.initials: H
authors.lastname: Limburg
authors.forename: Nel
authors.initials: N
authors.lastname: Tijmes
authors.forename: Maria
authors.initials: M
authors.lastname: van Genderen
authors.forename: José
authors.initials: J
authors.lastname: Schuil
authors.forename: Ruth
authors.initials: R
authors.lastname: van Nispen
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001766:Blindness / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005128:Eye Diseases / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D017678:Sex Distribution; D015354:Vision, Low / Q000453:epidemiology* / Q000209:etiology; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*; D055815:Young Adult