Vision impairment in Liverpool: prevalence and morbidity

A database related to the activities of the Liverpool vision assessment team was used to identify all children with vision impairment aged 0-16 years, resident in Liverpool, UK, on 1 April 1995. Prevalence rates were calculated for all children with vision impairment, and separately for two groups: those with uncomplicated vision impairment, and those with additional pathology. Visual tract pathologies were tabulated and compared. Associated handicapping conditions were defined and the extent of multiple disability was investigated for all vision impaired children, for very low birthweight children, and for those with cortical visual impairment. Of 199 children with vision impairment, 69 (35%) had uncomplicated impairment and 130 (65%) had additional and usually multiple pathology. There were 111 boys (56%); the excess of males was not statistically significant. Prevalence rates per 10,000 population were 18.1 for all vision impairment, 6.3 for uncomplicated vision impairment, and 11.8 for vision impairment complicated by additional pathology. Genetically determined disease accounted for over half the cases of uncomplicated vision impairment. Among the 130 children with additional pathology, cortical visual impairment was the commonest visual tract finding, affecting 64 (49%); 86% had learning difficulties; 53% had cerebral palsy. Multidisability (two or more disabling conditions in addition to vision impairment) affected half the entire childhood vision impairment population. These data should assist health and education authorities to determine the size of the vision impairment problem and how it relates to other disabilities in childhood, and can facilitate resource allocation and service planning.