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Paediatric visual impairment in Western Australia: Results and lessons from a registry analysis
Joshua R Taylor1, Rachael Ch Jeffery2, Angus Cook1
1School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia.
Insights
Paediatric visual impairment registrations are rising in Western Australia, though registry data has limitations. Improvements in data collection and practitioner engagement are needed for accurate epidemiology of childhood vision loss.
Area of Science:
- Ophthalmology
- Public Health
- Epidemiology
Background:
- Clinical registries are vital for understanding vision loss in children.
- Previous data on paediatric visual impairment in Western Australia is limited.
Purpose of the Study:
- To update the epidemiology of visual impairment in Western Australian children using registry data.
- To identify challenges in paediatric vision loss registry data collection.
Main Methods:
- Retrospective analysis of visual impairment and blindness registrations for children aged 0-16 years in Western Australia (1996-2015).
- Defined blindness as visual acuity ≤6/60 or visual field ≤20°.
- Assessed primary causes of vision loss and analyzed registration rate trends.
Main Results:
- 710 children received 728 certificates (6.2%) out of 11,800 issued.
- Inherited retinal disease, cortical visual impairment, and albinism were leading causes.
- Annual visual impairment registration rates increased (0.5 to 9.8 per 100,000), while blindness rates decreased (2.7 to 1.3).
Conclusions:
- Paediatric visual impairment registration rates are increasing in Western Australia.
- Trends require cautious interpretation due to registry data limitations.
- Digitization, patient outcome data, and practitioner incentives can enhance the registration process.
Aim:
Clinical registries are an important research tool to enhance our understanding of vision loss in the Australian paediatric population. We aim to provide an update on the epidemiology of visual impairment among Western Australian children using registry data analysis, and to highlight the challenges of registry data collection.
Methods:
This is a retrospective study of visual impairment and blindness registrations of children aged 0-16 years in Western Australia from 1996 to 2015. Blindness was defined as visual acuity ≤6/60 in the better-seeing eye or binocular visual field ≤20° diameter, with all other certifications labelled as visual impairment. Certificates were assessed for primary causes of vision loss by age strata and sex. Registration rate trends were analysed across three discrete registration periods.
Results:
Of 11 800 certificates issued between 1996 and 2015, 728 certificates (6.2%) were issued to 710 children. Five hundred and twenty-nine (74.5%) certificates were issued for visual impairment and 181 (25.5%) for blindness. The leading cause of certification was inherited retinal disease (73, 10.3%), followed by cortical visual impairment (57, 8.0%) and albinism (56, 7.9%). The annual registration rate of visual impairment increased from 0.5 to 9.8 per 100 000 person-years across the study period, whereas blindness rates fell from 2.7 to 1.3.
Conclusions:
Overall registration rates of paediatric visual impairment in Western Australia are increasing, but these trends should be interpreted with caution given the known limitations of registry data. Enhancements of the registration process could be achieved through digitisation, inclusion of patient outcome data, and incentives for greater practitioner engagement.
