Description of Research Report: Changes in Patterns of Age-Related Visual Impairment in the Netherlands: A Comparison of Two Cohorts of Patients Referred to Rehabilitation Programs 10 Years Apart
In developed countries, age-related eye diseases represent the major workload in general ophthalmology. Despite all modern technology and knowledge, it is not possible to improve vision in all the persons with these diseases. As a result of the aging of the population, the number of persons with incurable eye diseases, particularly age-related macular degeneration (AMD), is expected to increase in the next decades (de Boer, Jansonius, Langelaan, & van Rens, 2004; Buch et al., 2004; Pizzarello, 1987; Wormald, Wright, Courtney, Beaumont, & Haines, 1992). This increase will have great consequences for elderly people, the society, and the practice of ophthalmology in low vision clinics. Most of the studies of the causes of visual impairment have been population-based studies (that is, they studied a representative sample of a population, country, or region) (Buch et al., 2004; Dimitrov, Mukesh, McCarty, & Taylor, 2003; Foran, Wang, & Mitchell, 2002; Klaver, Wolfs, Vingerling, Hofman, & de Jong, 1998; Nucci et al., 2005; Pizzarello, 1987; Saw, Foster, Gazzard, & Seah, 2004; van Splunder, Stilma, Bernsen, & Evenhuis, 2004; Weih, Van Newkirk, McCarty, & Taylor, 2000; Wormald et al., 1992). These population-based studies provide important information on the incidence and prevalence of "theoretical" eye problems in a community. (By theoretical
we mean those with a visual acuity of ≤ 0.30 or a visual field restricted to less than 20 degrees in the better eye.) However, not all those who are visually impaired, from a theoretical point of view, consider themselves as such and hence will not visit an ophthalmologist or accept the offer of low vision counseling. Others are unaware of the possibilities of rehabilitation or are not able to come to these clinics because of health problems, mental difficulties, or other reasons (Muñoz et al., 1999). This discrepancy between population-based studies and daily practice makes it difficult to develop strategies to offer low vision services to those who need them. In addition, little is known about the changes in patterns of visual impairment over time. Therefore, there is still a place for hospital-based or patient-based studies of the incidence and etiology of visual impairment. The aim of this study was to determine changes, over time, in the incidence and etiology of visual impairment in persons aged 50 and older who visited an eye clinic for an incurable age-related eye disease and who accepted an offer of rehabilitation.