Long-term impact of retinal screening on significant diabetes-related visual impairment in the working age population

Diabetic retinopathy has long been regarded as the commonest preventable cause of blindness in the working age population. The aim was to determine if consistent annual screening for treatable retinopathy decreased the incidence of new blindness. We collated the causes of blindness for a 5-year period between 2001 and 2005 for the 16- to 64-year age group in a district that had operated systematic retinal screening in diabetes since 1986. Diabetic retinopathy was found to be the second commonest cause of blindness, with optic atrophy being the commonest cause in Newcastle District. This differs from national data showing diabetic retinopathy to be the commonest cause. Diabetic retinopathy was also the second commonest cause of partial sightedness registrations, with stroke being the commonest cause. Overall, stroke disease accounted for 16.2% and diabetic retinopathy for 15.4% of registrations. The annual incidence of blindness was 0.22 per 1000 with diabetes and of partial sightedness 0.43 per 1000 with diabetes. In a district that has operated retinal screening since 1986, diabetic retinopathy was not the commonest cause of blindness in the working age population, consistent with an effect of systematic annual screening.