Skip to main content

Incidence and causes of visual impairment in Japan: the first nation-wide complete enumeration survey of newly certified visually impaired individuals



To investigate the visual impairment certification status in Japan.

Study design

Observational cross-sectional study.


We asked all welfare offices throughout Japan to submit data concerning age, sex, causative diseases, and visual impairment grades for newly certified visually impaired individuals aged ≥ 18 years in the fiscal year of 2015. The certification was based on criteria of the Act on Welfare of Physically Disabled Persons.


In total, data were collected for 12,505 newly certified visually impaired individuals. The most common age group for these individuals was 80-89 years (29.6%), followed by 70-79 (26.3%) and 60-69 (17.3%) years. The most common causative disease was glaucoma (28.6%), followed by retinitis pigmentosa (14.0%), diabetic retinopathy (12.8%), and macular degeneration (8.0%). Glaucoma was the most common causative disease in both sexes (30.2% in men and 27.0% in women). The most common impairment grade was grade 2 (31.8%), followed by grades 5 (24.3%) and grade 1 (16.1%). The number of visually impaired individuals with underlying glaucoma had increased in comparison with the number in the most recent surveys (from fiscal years 2007 to 2009), whereas the number of individuals with underlying diabetic retinopathy and macular degeneration had decreased.


To our knowledge, this is the first nation-wide complete enumeration survey of newly certified visually impaired individuals in Japan. These findings may contribute to administrative activities concerning medical welfare as well as educational activities for preventing visual impairment.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5


  1. Klein BE, Klein R, Lee KE, Cruickshanks KJ. Performance-based and self-assessed measures of visual function as related to history of falls, hip fractures, and measured gait time. The beaver dam eye study. Ophthalmology. 1998;105:160–4.

    Article  CAS  PubMed  Google Scholar 

  2. Ivers RQ, Cumming RG, Mitchell P, Attebo K. Visual impairment and falls in older adults: the blue mountains eye study. J Am Geriatr Soc. 1998;46:58–64.

    Article  CAS  PubMed  Google Scholar 

  3. Lord SR, Dayhew J. Visual risk factors for falls in older people. J Am Geriatr Soc. 2001;49:508–15.

    Article  CAS  PubMed  Google Scholar 

  4. Coleman AL, Stone K, Ewing SK, Nevitt M, Cummings S, Cauley JA, et al. Higher risk of multiple falls among elderly women who lose visual acuity. Ophthalmology. 2004;111:857–62.

    Article  PubMed  Google Scholar 

  5. Chia E-M, Mitchell P, Ojaimi E, Rochtchina E, Wang JJ. Assessment of vision-related quality of life in an older population subsample: the blue mountains eye study. Ophthalmic Epidemiol. 2006;13:371–7.

    Article  PubMed  Google Scholar 

  6. Hayman KJ, Kerse NM, La Grow SJ, Wouldes T, Robertson MC, Campbell AJ. Depression in older people: visual impairment and subjective ratings of health. Optom Vis Sci. 2007;84:1024–30.

    Article  PubMed  Google Scholar 

  7. Renaud J, Levasseur M, Gresset J, Overbury O, Wanet-Defalque M-C, Dubois M-F, et al. Health-related and subjective quality of life of older adults with visual impairment. Disabil Rehabil. 2010;32:899–907.

    Article  PubMed  Google Scholar 

  8. McCarty CA, Nanjan MB, Taylor HR. Vision impairment predicts 5 year mortality. Br J Ophthalmol BMJ Publ Group. 2001;85:322–6.

    Article  CAS  Google Scholar 

  9. Ministry of Internal Affairs and Communications Accessed 15 Feb 2018.(in Japanese).

  10. Nakae K, Kogure F, Nagaya Y, Mishima S. Wagakuniniokeru shikakusyogai no genkyo. J Health Welf Stat (Kousei no Shihyo). 1991;38:13–22 (in Japanese).

    Google Scholar 

  11. Nakae K, Masuda K, Ishibashi T. Recent causes of visual disturbances in Japan—comparison with causes 15 years ago. J Clin Exp Med (Igaku no Ayumi). 2008;225:691–3 (in Japanese).

    Google Scholar 

  12. Wako R, Yasukawa T, Kato A, Omori T, Ishida S, Ishibashi T, et al. Causes and prevalence of visual impairment in Japan. Nippon Ganka Gakkai Zasshi. 2014;118:495–501 (in Japanese).

    PubMed  Google Scholar 

  13. Yamada M, Hiratsuka Y, Roberts CB, Pezzullo ML, Yates K, Takano S, et al. Prevalence of visual impairment in the adult Japanese population by cause and severity and future projections. Ophthalmic Epidemiol. 2010;17:50–7.

    Article  PubMed  Google Scholar 

  14. Ministry of Health, Labour and Welfare. Accessed 15 Feb 2018. (in Japanese).

  15. Ikesugi K, Ichio T, Tsukitome H, Kondo M. Annual incidences of visual impairment during 10-year period in Mie prefecture. Japan. Jpn J Ophthalmol. 2017;61:293–8.

    Article  PubMed  Google Scholar 

  16. Al-Haddad CE, Abdulaal M, Al-Moujahed A, Ervin A-M, Ismail K. Fornix-based versus limbal-based conjunctival trabeculectomy flaps for glaucoma: findings from a Cochrane systematic review. Am J Ophthalmol. 2017;174:33–41.

    Article  PubMed  Google Scholar 

  17. Chen DZ, Sng CCA. Safety and efficacy of microinvasive glaucoma surgery. J Ophthalmol. 2017;2017:3182935.

    PubMed  PubMed Central  Google Scholar 

  18. Tseng VL, Coleman AL, Chang MY, Caprioli J. Aqueous shunts for glaucoma. Cochrane Database Syst Rev. 2017;7:CD004918.

    PubMed  Google Scholar 

  19. Ministry of Health, Labour and Welfare. Accessed 15 Feb 2018. (in Japanese).

  20. Ministry of Health, Labour and Welfare. Accessed 15 Feb 2018. (in Japanese).

  21. Neville SE, Boye KS, Montgomery WS, Iwamoto K, Okamura M, Hayes RP. Diabetes in Japan: a review of disease burden and approaches to treatment. Diabetes Metab Res Rev. 2009;25:705–16.

    Article  PubMed  Google Scholar 

  22. Fonseca VA. New developments in diabetes management: medications of the 21st century. Clin Ther. 2014;36:477–84.

    Article  CAS  PubMed  Google Scholar 

  23. Yasuda M, Kiyohara Y, Hata Y, Arakawa S, Yonemoto K, Doi Y, et al. Nine-year incidence and risk factors for age-related macular degeneration in a defined Japanese population the Hisayama study. Ophthalmology. 2009;116:2135–40.

    Article  PubMed  Google Scholar 

  24. Mandai M, Watanabe A, Kurimoto Y, Hirami Y, Morinaga C, Daimon T, et al. Autologous induced stem-cell-derived retinal cells for macular degeneration. N Engl J Med. 2017;376:1038–46.

    Article  CAS  PubMed  Google Scholar 

  25. Morimoto N, Ohtsuki H. Low-vision service in the department of ophthalmology, Okayama university medical school. Atarashii Ganka (J Eye). 1999;16:587–93 (in Japanese).

    Google Scholar 

  26. Tanito M, Miyake T, Ohira A. The rate of official registration oflegally visually handicapped patients in the handbook of thephysically handicapped. Atarashii Ganka (J Eye). 2000;17:1315–8 (in Japanese).

    Google Scholar 

  27. Fujita A, Saito K, Ando N, Ogawa I, Abe H. Current status of registration as visually handicapped by outpatients in Niigata Prefecture. Rinsho Ganka (Jpn J Clin Ophthalmol). 1999;53:725–8 (in Japanese).

    Google Scholar 

  28. Ministry of Health, Labour and Welfare. Accessed 15 Feb 2018. (in Japanese).

Download references


We would like to thank Keisuke Kanenaga, Mio Sakate, Asuka Inagaki, Yasuhito Goto, Juri Akita, and other medical staff members at the Department of Ophthalmology in the Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences for their contribution to the present survey. The survey was supported by Health and Labour Sciences Research Grants for Research on Rare and Intractable Diseases.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Yuki Morizane.

Ethics declarations

Conflicts of interest

Y. Morizane, None; N. Morimoto, None; A. Fujiwara, None; R. Kawasaki, None; H. Yamashita, None; Y. Ogura, None; F. Shiraga, None.

Additional information

Corresponding author: Yuki Morizane

Electronic supplementary material

About this article

Verify currency and authenticity via CrossMark

Cite this article

Morizane, Y., Morimoto, N., Fujiwara, A. et al. Incidence and causes of visual impairment in Japan: the first nation-wide complete enumeration survey of newly certified visually impaired individuals. Jpn J Ophthalmol 63, 26–33 (2019).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Visual impairment
  • Japan
  • Glaucoma
  • Diabetic retinopathy
  • Survey