Trends over time in the incidence of congenital anophthalmia, microphthalmia and orbital malformation in England: database study

Aims To study trends over time in the incidence of congenital anophthalmia, microphthalmia, and orbital malformations in England, along with changes in hospital admission rates for these conditions. Methods Using English national hospital episode statistics, the annual rate of hospital admissions related to anophthalmia (1990-2011), microphthalmia (1990-2011) and congenital malformations of orbit/ of lacrimal apparatus (1999-2011) were calculated per 100,000 infants. The records were person-linked from 1999 to 2011, which enabled annual person-based ‘first record’ rates to be calculated as proxies for incidence. Results The annual incidence of congenital anophthalmia remained stable in England over the period 1999-2011 at approximately 1.5 (95% CI 1.2-1.8) cases per 100,000 infants. The annual incidence of congenital microphthalmia increased modestly in recent years, for example from 5.9 (95% CI 3.9-7.8) cases per 100,000 infants in 2004 to 11.4 (95% CI 8.9-14.0) in 2010. The annual incidence of hospitalised congenital orbital/lacrimal malformations remained steady over the study period. Counting multiple admissions per person, annual admission rates for anophthalmia fluctuated but generally remained stable. They doubled for microphthalmia from 11.0 (95% CI 8.4-13.5) admissions per 100,000 infants in 1990 to 22.1 (95% CI 17.7-24.6) in 2011. They showed a small non-significant increase for orbital/lacrimal malformations. Conclusion The incidence of congenital anophthalmia has remained stable in England in recent years, as has that of congenital orbital/lacrimal malformations, while the incidence of microphthalmia has increased modestly. Hospital admission rates for this group of conditions increased over time. These data may be useful for planning service provision.