title: Leading causes of certifiable visual loss in England and Wales during the year ending 31 March 2013.
abstract: OBJECTIVE
  The last article on causes of sight impairment (SI) in England and Wales was for April 2007-March 2008. This report updates these figures for April 2012-March 2013.
  
  
  METHODS
  In England and Wales, registration for SI is initiated by completion of a certificate of vision impairment (CVI). The main cause of visual impairment was ascertained for certificates completed April 2012-March 2013. A proportional comparison against April 2007-March 2008 was made.
  
  
  RESULTS
  We received 24 009 CVIs of which 10 410 were for severe sight impairment (SSI) and 13 129 were for SI. These numbers were slightly higher than those observed in April 2007-March 2008 (9823 SSI; 12 607 SI). The ratio SI:SSI has remained static with 55% of all certifications being SI. The proportion of certificates without a single main cause has fallen slightly (16.6 to 14%). The proportion of certificates with a main cause of degeneration of the macula and posterior pole (mostly age-related macular degeneration (AMD)) decreased from 58.6 to 50% SSI and from 57.2 to 52.5% SI. Glaucoma remains the second most common cause (11% SSI; 7.6% SI) but hereditary retinal disorders overtook diabetes as third leading cause of SSI.
  
  
  CONCLUSIONS
  AMD is still by far the leading cause of certifications for sight impairment in England and Wales (both SI and SSI). Proportionate changes have been observed since 2008, but it is important to note that a proportionate increase in one condition will impact on others.
authors.affiliation: Department of R&D, NIHR BRC for Ophthalmology, Moorfields and UCL Institute of Ophthalmology, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Quartilho
authors.affiliation: Royal National Institute of Blind People (RNIB), London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Simkiss
authors.affiliation: Department of R&D, NIHR BRC for Ophthalmology, Moorfields and UCL Institute of Ophthalmology, London, UK.
authors.forename: A
authors.identifier: http://orcid.org/0000-0001-9587-8526
authors.initials: A
authors.lastname: Zekite
authors.affiliation: Department of R&D, NIHR BRC for Ophthalmology, Moorfields and UCL Institute of Ophthalmology, London, UK.
authors.forename: W
authors.initials: W
authors.lastname: Xing
authors.affiliation: Department of R&D, NIHR BRC for Ophthalmology, Moorfields and UCL Institute of Ophthalmology, London, UK.|Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Wormald
authors.affiliation: Department of R&D, NIHR BRC for Ophthalmology, Moorfields and UCL Institute of Ophthalmology, London, UK.|Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Bunce
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000453:epidemiology* / Q000209:etiology; D003930:Diabetic Retinopathy / Q000150:complications / Q000453:epidemiology; D004185:Disability Evaluation; D004739:England / Q000453:epidemiology; D005128:Eye Diseases / Q000150:complications / Q000453:epidemiology*; D005260:Female; D005901:Glaucoma / Q000150:complications / Q000453:epidemiology; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000453:epidemiology; D008297:Male; D009896:Optic Atrophy / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data; D012164:Retinal Diseases / Q000150:complications / Q000453:epidemiology; D015354:Vision, Low / Q000453:epidemiology* / Q000209:etiology; D014852:Wales / Q000453:epidemiology
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