Incidence of blindness and severe visual impairment in Germany: projections for 2030.

Purpose: Estimates of the incidences of severe visual impairment and blindness (SVI/B) and their causes are key to good health service planning. Thus, the database of Germany's largest state's blind registry was used to estimate current incidence rates (IR) and to project rates for Germany in 2010 and 2030.
Methods: The sample consisted of 3328 blind/severely visually impaired individuals newly registered between 2000 and 2008. According to German law, SVI and B were defined as visual acuity equal to or below 20/1000 and 20/400, respectively, in the better seeing eye. Data of the reference population were stratified by age and sex and were used to estimate current IRs. Standardized IRs were estimated for Germany for 2010 and 2030 using national demographic projections.
Results: Age-related macular degeneration (AMD) accounted for 50% of all incidence of SVI/B (5.56/100,000 personyears (PY), followed by glaucoma (15%; 1.65/100,000 PY) and diabetic eye disease (10%; 1.16/100,000 PY). All current IRs will rise by 2030, with the most pronounced increase in AMD. By 2030, a national AMD IR of 9.5/100,000 PY is expected, accounting for 57% of all incidence of SVI/B in Germany. The incidence of SVI/B in women will be more than twofold compared to men in 2030 (9187 vs. 3716 incident cases in 2030).
Conclusions: There will be a dramatic increase of SVI/B by 2030 in Germany, leading to a substantial increase in the need for health and social service provision, with a focus on visually impaired elderly women.