People in Wales with impaired vision have recently benefited from the arrival of a new nationwide community based low vision service. Undoubtedly, this is a dramatic and welcome development for all those with untreatable sight loss, not just those registered blind or partially sighted. But what has motivated the Welsh Assembly to take this radical step?

One reason is that visual impairment in Wales, like the rest of the United Kingdom, is reaching epidemic proportions. Since 1982, the number of people in the United Kingdom registered blind and partially sighted¹ has almost doubled and now stands at 359 000.^2–4 However, the registers are known to underestimate the number with untreatable sight loss by a factor of twofold to threefold and so there may be more than 1 000 000 people in the United Kingdom with untreatable low vision.^5,6 This estimate is supported by a recent Medical Research Council trial that has established that one in five people over the age of 75 have a binocular visual acuity below 6/12.⁷ In many parts of Wales, the combined prevalence of registerable visual impairment (that is, both blind and partial sight registrations) now exceeds 2%.⁸ The magnitude of the problem will undoubtedly increase because most sight threatening eye disease is age related and the number of people aged 60 and over is projected to increase by 57% over the next 30 years.⁹

Another reason for the Welsh Assembly’s decision is that the …