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6220 institutionalised people with intellectual disability referred for visual assessment between 1993 and 2003: overview and trends
  1. C E D van Isterdael1,
  2. J S Stilma2,
  3. P D Bezemer3,
  4. N T Tijmes1
  1. 1Bartiméus, Zeist, The Netherlands
  2. 2Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands
  3. 3Department of Clinical Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands
  1. Correspondence to: N T Tijmes Bartiméus, Medische Dienst, Postbus 1003, 3700 BA Zeist, The Netherlands; n.tijmes{at}


Aims: To summarise the results of visual performance tests and other data of institutionalised people with intellectual disability referred to a visual advisory centre (VAC) between 1993 and 2003, and to determine trends in these data.

Methods: A retrospective medical record review was undertaken of 6220 consecutive people examined ophthalmologically according to a standard protocol by one VAC that specialised in visual assessment and treatment of people with intellectual disability, between 1993 and 2003. χ2 test for linear trend was used and linear regression coefficients were calculated.

Results: The proportion of people aged ⩾50 years increased from 19.3% to 34.2% between 1995 and 2003 (p<0.001); the combined figure of severe or profound intellectual disability decreased from 80.0% to 52.6% (p<0.001); the proportion of mobile people increased from 52.1% to 98.0% (p<0.001); the combined proportion of people with visual impairment or blindness decreased from 70.9% to 22.9% (p<0.001), and that of people with visual disorders decreased from 89.6% to 75.3% (p<0.001). Causes of intellectual disability were identified in 58.4% people; 20.8% had Down’s syndrome.

Conclusion: Many ocular diagnoses were found, indicating the need for ophthalmological monitoring. Specialised centres are helpful, because assessment and treatment of people with intellectual disability is complicated and time consuming. Protocols for efficient referral will have to be developed. A major task lies ahead to improve the treatment rates of refractive errors, cataract and strabismus, and to find specific causes of intellectual disability.

  • CVI, cerebral visual impairment
  • VAC, visual advisory centre

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  • Published Online First 19 July 2006

  • Funding: This study was funded by Bartiméus, Zeist, The Netherlands.

  • Competing interests: None declared.

  • Ethical approval: The Ethics Committee of Bartiméus, Doorn, The Netherlands, approved the research protocol.

    Subjects or their caretakers signed an informed consent for us to use their electronic records anonymously for scientific purposes.