NEW BLINDNESS IN DIABETES REDUCED BY MORE THAN ONE-THIRD IN STOCKHOLMCOUNTY

To monitor changes over time in the incidence of blindness among peopl e with diabetes, referrals (mentioning diabetes) to all vision rehabil itation centres in Stockholm County (1995 population 1 725 756) during 1981-1995 were registered. A mass mailing to people with diabetes in 1989 urged them to have their eyes examined. Mobile fundus photography teams initiated early diagnosis of diabetic retinopathy in primary he alth care in 1990. Referrals with diabetes and blindness, defined (WHO , ICD 10) as best-corrected visual acuity (VA) of the better eye less than 3/60 (0.05), occurred for 172 persons (7.6 % of those referred wi th diabetes). During 1981-1985, 93 were referred (95 % confidence inte rval 75 to 114); 1986-1990, 51 (38 to 67); 1991-1995, 28 (19 to 41). F ive-year average annual incidence rate of referrals with blindness was reduced by 47 % from 1.2 to 0.63 to 0.33 per 100 000 population. Mean yearly reduction during 1981-1995 was 11 % (8 to 15 %), 11.5 % (8 is 15 %) if blindness was defined as in the UK (VA 3/60 or less), and 7 % (4 to 9 %) for legal blindness (VA 6/60 or less); test for trend p < 0.001 (Poisson regression analysis). This is the first report of reduc tion in a geographical region of a proxy measure for new blindness in diabetes by one-third or more, attaining one of the main targets of th e St Vincent Declaration. (C) 1997 by John Wiley & Sons, Ltd.