TY - JOUR
T1 - Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020
T2 - The Right to Sight: An analysis for the Global Burden of Disease Study
AU - GBD 2019 Blindness and Vision Impairment Collaborators on behalf of the Vision Loss Expert Group of the Global Burden of Disease Study
AU - Steinmetz, Jaimie D.
AU - Bourne, Rupert R.A.
AU - Briant, Paul Svitil
AU - Flaxman, Seth
AU - Taylor, Hugh R.
AU - Jonas, Jost B.
AU - Abdoli, Amir
AU - Abrha, Woldu Aberhe
AU - Abualhasan, Ahmed
AU - Abu-Gharbieh, Eman
AU - Adal, Tadele Girum
AU - Afshin, Ashkan
AU - Ahmadieh, Hamid
AU - Alemayehu, Wondu
AU - Alemzadeh, Sayyed Amirpooya
AU - Alfaar, Ahmed Samir
AU - Alipour, Vahid
AU - Androudi, Sofia
AU - Arabloo, Jalal
AU - Arditi, Aries
AU - Aregawi, Brhane Berhe
AU - Arrigo, Alessandro
AU - Ashbaugh, Charlie
AU - Ashrafi, Elham
AU - Atnafu, Desta Debalkie
AU - Bagli, Eleni
AU - Baig, Atif Amin
AU - Bärnighausen, Till Winfried
AU - Parodi, Maurizio Battaglia
AU - Beheshti, Mahya
AU - Bhagavathula, Akshaya Srikanth
AU - Bhardwaj, Nikha
AU - Bhardwaj, Pankaj
AU - Bhattacharyya, Krittika
AU - Bijani, Ali
AU - Bikbov, Mukharram
AU - Bottone, Michele
AU - Braithwaite, Tasanee
AU - Bron, Alain M.
AU - Nagaraja, Sharath Burugina
AU - Butt, Zahid A.
AU - Luciano Caetano dos Santos, Florentino
AU - Carneiro, Vera L.A.
AU - Casson, Robert James
AU - Cheng, Ching Yu
AU - Choi, Jee Young Jasmine
AU - Chu, Dinh Toi
AU - Cicinelli, Maria Vittoria
AU - Coelho, João M.
AU - Househ, Mowafa
N1 - Publisher Copyright:
© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2021/2
Y1 - 2021/2
N2 - Background: Many 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. Methods: We 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. Findings: Global 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]). Interpretation: Results 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. Funding: Brien Holden Vision Institute, Fondation Théa, The Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.
AB - Background: Many 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. Methods: We 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. Findings: Global 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]). Interpretation: Results 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. Funding: Brien Holden Vision Institute, Fondation Théa, The Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.
UR - https://www.scopus.com/pages/publications/85099179366
U2 - 10.1016/S2214-109X(20)30489-7
DO - 10.1016/S2214-109X(20)30489-7
M3 - Article
C2 - 33275949
AN - SCOPUS:85099179366
SN - 2214-109X
VL - 9
SP - e144-e160
JO - The Lancet Global Health
JF - The Lancet Global Health
IS - 2
ER -