Gordon-Bennett et al an assessment against the Service Objectives and Quality Assurance Standards for the programme. All programmes in England and Wales will be required to use a report template in order to facilitate the collation and comparison of data.4 Locally derived data on new VI should be included in the annual report submitted to the National Screening Programme. Prior to 2005, screening for DR in Cambridgeshire was largely hospital-based, with patients being referred by their general practitioners, diabetic physicians, or optometrists directly to ophthalmologists at either Addenbrookes or Hinchingbrooke Hospital. Optometrists have recently been trained to perform optometric based screening, and to refer patients in a timely manner with maculopathy (M1), preprolif- erative retinopathy (R2), and proliferative retinopathy (R3). In November 2003, the CVI replaced the BD8 form in England. The new forms allowed space to record the patient’s visual function. Table 1 shows the deﬁnitions of severe VI and VI. These apply to the function of the better eye; people with good vision in one eye are not eligible for certiﬁcation. This is the first study to obtain the severe VI and VI registration rates predominantly due to DR in south Cambridgeshire, Cambridge city, and Huntingdonshire. It was performed to establish a reference point of VI registration due to DR at the beginning of the screening program. Methods A retrospective review of all CVI for patients with Cambridgeshire post codes over 24 months from January 1, 2004 to December 31, 2005 was conducted. The type of VI, cause of VI and patient’s age were noted for each form. An attempt was made to validate the certiﬁcates of VI with the central list of all new registrations of VI held by Cambridgeshire Social Services. Population data was obtained from Census 2001 and Cambridgeshire primary care trusts to determine the total and diabetic populations of South Cambridgeshire, Cambridge city and Huntingdon. We had to exclude East Cambridgeshire and the Fenlands as patients from these areas attend other local district general hospitals eg, Queen Elizabeth Hospital King’s Lynn for VI assessment and registration. The annual registration rates of severe VI and VI due to DR were calculated per million population per year. In addition, the rate per million diabetic patients and prevalence of diabetes were calculated. Results From January 1, 2004 to December 31, 2005, there were 367 CVI for patients from Cambridgeshire, Cambridge city, and Huntingdonshire. Two forms were incomplete (the type of VI was not stated). Of the 365 completed forms there were 156 severe VI and 209 VI registrations. Some patients had more than one cause of VI. Each cause was noted which resulted in the number of causes (384) exceeding the number of registration forms (365). The leading causes of VI registra- tion were age-related macular degeneration in 224 or 61.4% of patients, glaucoma (43 or 11.8%), and optic neuropathy (27 or 7.4%), (Table 2). According to Census 2001, the total population of South Cambridgeshire, Cambridge City and Huntingdonshire is 395,933. The number of registrations predominantly due to DR was 18; 13 visually impaired and 5 with severe VI. The rates of severe VI and VI registration predominantly due to DR were 17.1 and 6.5 per million per year, respectively. The diabetic population of South Cambridgeshire (2729), Cam- bridge City (3361) and Huntingdonshire (4752) in June 2005 was 10,842, and the prevalence of diabetes in this population of Cambridgeshire is calculated to be 2.74%. The severe VI and VI registration rates in the diabetic population were 230 and 600 per million population with diagnosed diabetes per year, respectively. These results are summarized in Table 3. Discussion In our study, DR was the ﬁfth leading cause of registered VI, superseded by age-related macular degeneration, glaucoma, optic neuropathy, and visual cortex disorder in that order. Table 1 Deﬁnitions of severe visual impairment and visual impairment used in the UK (apply to the better eye) Severe visual impairment Visual impairment Worse than 3/60 (corrected visual acuity) 3/60 or 6/60 with full visual ﬁeld or or Worse than 6/60 with very contracted visual ﬁelds 6/24 or worse with moderate constriction of visual ﬁeld or or 6/60 or above with a very contracted visual ﬁeld especially 6/18 or better with gross visual ﬁeld defects in the lower part of the ﬁeld 76 Clinical Ophthalmology 2009:3