Blindness and Visual Impairment: High-Income Countries

Abstract

Patterns and prevalence of visual impairment and blindness in high-income countries including all of Western Europe, Northern America and Australia are distinctly different from global estimates. As outlined in the previous chapter, global visual impairment and blindness is mostly found in low- and middle-income countries and is mainly due to a number of potentially preventable and/or treatable causes (Pascolini and Mariotti 2012). In comparison, in high-income countries, the prevalence and incidence of visual impairment and blindness is much lower and mostly due to causes related to the ageing of the population. A number of the main causes of visual impairment and blindness in these countries are currently not amenable to prevention, and treatment can be unsatisfactory in that it may only slow down the progression of a number of these diseases, but does not cure them. The main disorders are complex diseases, with a genetic and an environmental component, with ageing being often the single most important factor in the aetiology. Unfortunately, as visual impairment and blindness is not perceived as a large public health issue in many high-income countries, population-based cohort studies are scarce with no published population-based data available. A recent publication of global estimates of visual impairment by the World Health Organization (WHO) highlighted this shortcoming once again. Only two studies, conducted in Russia and Turkmenistan, qualified for inclusion in the estimations for Europe (Pascolini and Mariotti 2012). However, the considerable impact of visual impairment not only on an individual’s quality of life but also the substantial cost born by society merits significant research efforts and appropriate service provision in all high-income countries (Taylor et al. 2006; Porz et al. 2010). Not only does longevity continue to increase in all high-income countries but workplace requirements change rapidly as well. Visually impaired persons may often be particularly disadvantaged by these trends, in an economy driven increasingly by visual technology (West and Sommer 2001). Together with the age of retirement being up for discussion in a number of countries, this should create even more of an incentive for governments to invest into research and service provision in order to maintain lifelong good vision. In the following discussion, the prevalence and incidence estimates generated from a number of available population-based studies as well as similar estimates based on blind registers will be depicted, followed by a brief paragraph on visual impairment in the elderly and risk factors for blindness in high-income countries (which are discussed in more depth in Chaps. 4 and 5). Finally, currently available projections of future trends of visual impairment and blindness in high-income countries are discussed.