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Established in Britain in the 19th century, the sight impairment register has been the sole means of routinely monitoring the frequency and causes of visual impairment in children to plan services and prioritise research.1 Although not a prerequisite, certification and consequent registration is often the catalyst for statutory assessment of special educational needs. It is also often the portal for accessing social services.2 Certification remains voluntary in the UK, by contrast with similar registers elsewhere. However, considerable effort has recently been directed to addressing previous concerns about incomplete reporting of information and underascertainment of eligible individuals.1 2 We have previously reported incidence and causes of severe visual impairment (SVI) or blindness (BL) and associated mortality3 in a nationally representative group of children with SVI/BL in the UK. We now report on the BL certification status of these children 1 year after diagnosis.
Active surveillance was undertaken, simultaneously but independently, through the British Ophthalmological4 and British Paediatric5 Surveillance Units, whose reporting bases comprise all consultant ophthalmologists and paediatricians, respectively, in the UK. Every month for 1 year (2000), clinicians reported all children aged <16 years who were newly diagnosed as having SVI/BL due to any disorder. Children were eligible if they had a corrected distance visual acuity of worse than LogMAR 1.0 (Snellen 6/60 or equivalent) in the better eye, that is, SVI/BL using the WHO international taxonomy.6 Children were also considered eligible if their acuity could not be measured formally but they had clinical features …
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