Abstract
OBJECTIVE: The demand for eye-care services in the Netherlands is increasing. This article indicates the causes and attempts to provide an estimate of the increase between 2010 and 2020 and to indicate what will be the consequences. DESIGN: Descriptive study. METHOD: In the absence of data on the numbers of blind and visually impaired people in the Netherlands, we used data from the records of general practitioners, yearly statistics for the number of relevant activities in hospitals and a mathematical model to calculate the number of blind and visually impaired in the Netherlands. The data mentioned were extrapolated to the population of 2020. Additionally, the expected number of new treatments of neovascular age-related macular degeneration (AMD) and macular oedema in diabetic retinopathy and retinal venous occlusion were calculated by a model. RESULTS: The number of people over 65 in the Netherlands increases by 34% between 2010 and 2020. The registrations by general practitioners show an increase of 43% of patients with eye conditions. Modelling of the new treatment methods demonstrates a threefold increase of the number of treatments. Finally, it appears that the number of blind and visually impaired people increases by 20%. The prevalence of visual impairment is the highest in elderly in health-care institutions, mentally handicapped and elderly living independently. CONCLUSION: The demand for eye-care services will increase by 200-300% between 2010 and 2020. The most important cause for this is the new treatment for 'wet' AMD and macular oedema using intravitreal angiogenesis inhibitors. The capacity of eye care services needs to be increased, partly by a redistribution of tasks between different professional groups within the eye care sector. Routine vision screening of elderly in care institutions and people with a mental handicap can reduce the number of Dutch people with avoidable visual impairment. For elderly living independently, provision of information and selective screening is indicated.
