Certification of vision impairment relating to uveitis as main cause in England and Wales between 2009 and 2021

Abstract

Purpose : In England and Wales, individuals with sight loss meeting particular criteria are eligible for a
Certificate of Vision Impairment (CVI), which can enable access to support. Tracking trends relating
to particular causes can help in understanding changes in disease prevalence and burden of sight
loss relating to specific conditions. Here, we explored numbers of CVIs with uveitic conditions listed
as the single or main cause between 2009 and 2021.

Methods : CVI forms are sent to the Certification Office at Moorfields Eye Hospital, London. Annual numbers
were collated for each year (April to March of the following year) from 2009/10 to 2020/21. Total
numbers were noted, as well as CVIs in which a uveitic condition (including non-infectious and
infectious uveitis) was listed as the single or main cause. The gender distribution was also noted.

Results : In 2009/10, 24,231 CVIs were issued, of which 44 (0.18%) listed a uveitic condition as the main
cause. In 2018/19, 25,887 CVIs were issued, of which 66 (0.25%) had a uveitic cause. Over this period
the mean (SD) annual number of CVIs was 24,514 (600); the mean (SD) number and mean (SD)
proportion relating to uveitis were 54 (11) and 0.22 (0.04)% respectively. Annual uveitis-related CVIs
ranged between 35 and 68. In 2019/20, 24,903 CVIs were issued, of which 101 (0.41%) were uveitis-
related. Whilst the total number of CVIs was similar to previous years, the number of uveitis-related
CVIs was nearly double the annual mean of the previous decade. For 2020/2021, 17,547 CVIs were
issued, of which 80 (0.46%) were uveitis-related. In all of the years analysed, females accounted for
more than 50% of uveitis-related CVIs, and the proportion was similar to that found for CVIs overall.

Conclusions : Our study reports the proportions of CVIs relating to uveitic main causes over a 12 year period. In
2019/20, there was a significant increase in uveitis-related CVIs. In 2020/21, the total number of CVIs
dropped, related to the COVID-19 pandemic and associated lockdowns (as we have previously
reported), but the proportion of uveitis-related CVIs remained similar to the higher level seen in
2019/20. These findings invite further investigation to examine possible causes of the increase in
uveitis-related CVIs and whether this trend will continue. Newer treatments have emerged for
uveitis, but their impact on CVIs is not yet evident.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.