[Temporal trends in the etiology of blindness]

Blindness prevention is a primary goal in ophthalmology. The long term success (in some respect) is reflected by the development of causes of blindness (e.g. in the interspeciality problem area of diabetic blindness). In an attempt to study long term developments in blindness epidemiology the German Committee for the Prevention of Blindness initiated the present study.

The present investigation reviewed (nearly) all German population based studies on the epidemiology of causes of blindness. Thus 35 studies covering more than 100 years have been included. Timely trends have been investigated by comparing relative frequencies of the prevalence of causes of blindness.

Blindness prevalence increased in Germany during the historical observation time (present prevalence 138/100.000). The relative frequency of macular degeneration (presently the most frequent cause of blindness with approx. 15-20% share), diabetic retinopathy (present share approx. 5-7%) and high myopia (present share approx. 12-17%) have increased. The relative frequency of glaucoma (present share approx. 15%), tapetoretinal degenerations (present share approx. 5-10%) and retinal detachment (present share approx. 5-10%) have been more or less stable in the historical perspective. Cataract (present share approx. 5-10%), optic atrophy (present share approx. 5-10%), trauma (present share approx. < 5%), uveitis (present share approx. < 5%) and infections (presently only single cases) have diminished.

Blindness prevalence has slightly increased in Germany over the last 100 years. Infections, traumas and uveitis have virtually disappeared as a cause of blindness. Macular degeneration, glaucoma and high myopia, on the other hand are increasingly responsible for blindness in Germany.

From a preventive medicine standpoint the latter mentioned diseases should have priority in ophthalmologic research.