Dataset Information

Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study.

ABSTRACT:

Background

To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990-2020, and forecasts for 2050.

Methods

We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. Only studies with samples representative of the population and with clearly defined visual acuity testing protocols were included. We fitted hierarchical models to estimate 2020 prevalence (with 95% uncertainty intervals [UIs]) of mild vision impairment (presenting visual acuity ?6/18 and <6/12), moderate and severe vision impairment (<6/18 to 3/60), and blindness (<3/60 or less than 10° visual field around central fixation); and vision impairment from uncorrected presbyopia (presenting near vision FindingsIn 2020, an estimated 43·3 million (95% UI 37·6-48·4) people were blind, of whom 23·9 million (55%; 20·8-26·8) were estimated to be female. We estimated 295 million (267-325) people to have moderate and severe vision impairment, of whom 163 million (55%; 147-179) were female; 258 million (233-285) to have mild vision impairment, of whom 142 million (55%; 128-157) were female; and 510 million (371-667) to have visual impairment from uncorrected presbyopia, of whom 280 million (55%; 205-365) were female. Globally, between 1990 and 2020, among adults aged 50 years or older, age-standardised prevalence of blindness decreased by 28·5% (-29·4 to -27·7) and prevalence of mild vision impairment decreased slightly (-0·3%, -0·8 to -0·2), whereas prevalence of moderate and severe vision impairment increased slightly (2·5%, 1·9 to 3·2; insufficient data were available to calculate this statistic for vision impairment from uncorrected presbyopia). In this period, the number of people who were blind increased by 50·6% (47·8 to 53·4) and the number with moderate and severe vision impairment increased by 91·7% (87·6 to 95·8). By 2050, we predict 61·0 million (52·9 to 69·3) people will be blind, 474 million (428 to 518) will have moderate and severe vision impairment, 360 million (322 to 400) will have mild vision impairment, and 866 million (629 to 1150) will have uncorrected presbyopia.

Interpretation

Age-adjusted prevalence of blindness has reduced over the past three decades, yet due to population growth, progress is not keeping pace with needs. We face enormous challenges in avoiding vision impairment as the global population grows and ages.

Funding

Brien Holden Vision Institute, Fondation Thea, Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.

SUBMITTER: GBD 2019 Blindness and Vision Impairment Collaborators

PROVIDER: S-EPMC7820390 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study.

The Lancet. Global health 20201201 2

<h4>Background</h4>To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990-2020, and forecasts for 2050.<h4>Methods</h4>We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. Only stud ...[more]

PMID: 33275950

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Project description:BackgroundMany causes of vision impairment can be prevented or treated. With an ageing global population, the demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in avoidable vision impairment, defined as cataract and undercorrected refractive error.MethodsWe did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. We fitted hierarchical models to estimate prevalence (with 95% uncertainty intervals [UIs]) of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness (<3/60 or less than 10° visual field around central fixation) by cause, age, region, and year. Because of data sparsity at younger ages, our analysis focused on adults aged 50 years and older.FindingsGlobal crude prevalence of avoidable vision impairment and blindness in adults aged 50 years and older did not change between 2010 and 2019 (percentage change -0·2% [95% UI -1·5 to 1·0]; 2019 prevalence 9·58 cases per 1000 people [95% IU 8·51 to 10·8], 2010 prevalence 96·0 cases per 1000 people [86·0 to 107·0]). Age-standardised prevalence of avoidable blindness decreased by -15·4% [-16·8 to -14·3], while avoidable MSVI showed no change (0·5% [-0·8 to 1·6]). However, the number of cases increased for both avoidable blindness (10·8% [8·9 to 12·4]) and MSVI (31·5% [30·0 to 33·1]). The leading global causes of blindness in those aged 50 years and older in 2020 were cataract (15·2 million cases [9% IU 12·7-18·0]), followed by glaucoma (3·6 million cases [2·8-4·4]), undercorrected refractive error (2·3 million cases [1·8-2·8]), age-related macular degeneration (1·8 million cases [1·3-2·4]), and diabetic retinopathy (0·86 million cases [0·59-1·23]). Leading causes of MSVI were undercorrected refractive error (86·1 million cases [74·2-101·0]) and cataract (78·8 million cases [67·2-91·4]).InterpretationResults suggest eye care services contributed to the observed reduction of age-standardised rates of avoidable blindness but not of MSVI, and that the target in an ageing global population was not reached.FundingBrien Holden Vision Institute, Fondation Théa, The Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.

Project description:BackgroundCause-specific prevalence data of vision loss and blindness is fundamental for making public health policies and is essential for prioritizing scientific advances and industry research.MethodsCause-specific vision loss data from the Global Health Data Exchange was used. The burden of vision loss was measured by prevalence and years lived with disability (YLDs).FindingsIn 2019, uncorrected refractory error and cataract were the most common causes for vision loss and blindness globally. Women have higher rates of cataract, age-related macular degeneration (AMD), and diabetic retinopathy (DR) than men. In the past 30 years, the prevalence of moderate/severe vision loss and blindness due to neonatal disorders has increased by 13.73 and 33.53%, respectively. Retinopathy of prematurity (ROP) is the major cause of neonatal disorders related vision loss. In 2019, ROP caused 101.6 thousand [95% uncertainty intervals (UI) 77.5-128.2] cases of vision impairment, including 49.1 thousand (95% UI 28.1-75.1) moderate vision loss, 27.5 thousand (95% UI 19.3-36.60) severe vision loss and, 25.0 thousand (95% UI 14.6-35.8) blindness. The prevalence of new-onset ROP in Africa and East Asia was significantly higher than other regions. Variation of preterm birth prevalence can explain 49.8% geometry variation of ROP-related vision loss burden among 204 countries and territories. After adjusting for preterm prevalence, government health spending per total health spending (%), rather than total health spending per person, was associated with a reduced burden of ROP-related vision loss in 2019 (-0.19 YLDs for 10% increment). By 2050, prevalence of moderate, severe vision loss and blindness due to ROP is expected to reach 43.6 (95% UI 35.1-52.0), 23.2 (95% UI 19.4-27.1), 31.9 (95% UI 29.7-34.1) per 100,000 population.ConclusionThe global burden of vision loss and blindness highlights the prevalent of ROP, a major and avoidable cause for childhood vision loss. Advanced screening techniques and treatments have shown to be effective in preventing ROP-related vision loss and are urgently needed in regions with high ROP-related blindness rates, including Africa and East Asia.

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Dataset Information

Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study.

Background

Methods

Interpretation

Funding

Publications

Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study.

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