Causes of blindness in Hessia

Background Despite of medical progress the incidence and prevalence of blindness are continuously increasing. In Hessia, the number of persons receiving blindness compensation payment increased from 8,346 in 1985 to 11,166 in 1996 by 2.6% per year. In 1996, the rate (prevalence) amounted to 1.85 parts per thousand of the Hessian population. Methods In this study, the incidence of blindness (visual acuity less than or equal to 0.02 or equivalent visual handicap) and substantial visual handicap (visual acuity less than or equal to 0.05 or equivalent visual handicap) according to the Hessian law was investigated by means of the records of new candidates for blindness compensation payment whose applications were granted in 1996. The causes of blindness (main diagnosis), visual acuity, age, gender, and nationality were evaluated. Results The Hessian administration for public welfare had filed 2,609 alterations of applications concerning sundry social assistance. Out of these, 2,395 files (91.8%) were available. 1411 applications met the requirements for blindness compensation payment. 45.4% were graded substantially visually handicapped for the first time, 43.4% were graded blind for the first time, and 11.0% were graded blind after previous substantial visual handicap. In 0.2%, a further classification was not necessary. Applied to the Hessian population of 6.027 million people, the incidence of blindness was 0.14 parts per thousand. 67.9% were female, 30.9% were male, in 1.2% the gender was not evaluable. The age median of the candidates was 78 years (male: 74 years, female: 80 years), 84.3% of the candidates were greater than or equal to 60 years old. The most frequent causes of blindness (substantial visual handicap) were: age related macular degeneration 35.3% (49.5%), diabetic retinopathy 15.0% (17.0%), glaucoma 12.6% (7.8%), tapetoretinal degenerations 6.9% (1.7%), optic nerve atrophy 6.1% (4.3%), and myopia 5.0% (6.5%). Conclusion Age related affections are the most frequent causes of blindness. Due to the increasing life expectancy and rather constant birth rates, a further increase of blindness rates has to be expected.