Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study Journal Articles uri icon

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abstract

  • 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.

authors

  • Steinmetz, Jaimie D
  • Bourne, Rupert RA
  • Briant, Paul Svitil
  • Flaxman, Seth R
  • Taylor, Hugh RB
  • Jonas, Jost B
  • Abdoli, Amir Aberhe
  • Abrha, Woldu Aberhe
  • Abualhasan, Ahmed
  • Abu-Gharbieh, Eman Girum
  • Adal, Tadele Girum
  • Afshin, Ashkan
  • Ahmadieh, Hamid
  • Alemayehu, Wondu
  • Alemzadeh, Sayyed Amirpooya Samir
  • Alfaar, Ahmed Samir
  • Alipour, Vahid
  • Androudi, Sofia
  • Arabloo, Jalal
  • Arditi, Aries Berhe
  • Aregawi, Brhane Berhe
  • Arrigo, Alessandro
  • Ashbaugh, Charlie
  • Ashrafi, Elham Debalkie
  • Atnafu, Desta Debalkie
  • Bagli, Eleni Amin
  • Baig, Atif Amin Winfried
  • Bärnighausen, Till Winfried
  • Battaglia Parodi, Maurizio
  • Beheshti, Mahya Srikanth
  • Bhagavathula, Akshaya Srikanth
  • Bhardwaj, Nikha
  • Bhardwaj, Pankaj
  • Bhattacharyya, Krittika
  • Bijani, Ali
  • Bikbov, Mukharram
  • Bottone, Michele
  • Braithwaite, Tasanee M
  • Bron, Alain M
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  • Butt, Zahid A
  • Caetano dos Santos, Florentino Luciano L
  • Carneiro, Vera L James
  • Casson, Robert James
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  • Choi, Jee-Young Jasmine
  • Chu, Dinh-Toi
  • Cicinelli, Maria Vittoria M
  • Coelho, João MG
  • Congdon, Nathan GA
  • Couto, Rosa AA
  • Cromwell, Elizabeth AM
  • Dahlawi, Saad M
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  • Dana, Reza
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  • Ellwein, Leon B
  • Emamian, Mohammad Hassan
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  • Farzadfar, Farshad G
  • Fernandes, Arthur G
  • Fischer, Florian S
  • Friedman, David SM
  • Furtado, João M
  • Gaidhane, Shilpa
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  • George, Ronnie
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  • Hamidi, Samer Randall
  • Hammond, Billy Randall R
  • Hartnett, Mary Elizabeth R Kusuma
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  • Islam, Sheikh Mohammed Shariful
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  • Jayaram, Shubha Prakash
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  • Kahloun, Rim
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  • Kandel, Himal
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  • Pawar, Shrikant
  • Pesudovs, Konrad
  • Peto, Tunde Quang
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  • Podder, Vivek
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  • Skryabin, Valentin Yurievich Aleksandrovna
  • Skryabina, Anna Aleksandrovna
  • Soheili, Amin Bekele
  • Sorrie, Muluken Bekele ARC
  • Sousa, Raúl ARCT
  • Sreeramareddy, Chandrashekhar T
  • Stambolian, Dwight Girma
  • Tadesse, Eyayou Girma
  • Tahhan, Nina Ismail
  • Tareque, Md Ismail
  • Topouzis, Fotis Xuan
  • Tran, Bach Xuan
  • Tsegaye, Gebiyaw K
  • Tsilimbaris, Miltiadis K
  • Varma, Rohit
  • Virgili, Gianni
  • Vongpradith, Avina Thu
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  • Wang, Ya Xing
  • Wang, Ningli Hailay
  • Weldemariam, Abrha Hailay K
  • West, Sheila K Gebeyehu
  • Wondmeneh, Temesgen Gebeyehu Y
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  • Yaseri, Mehdi
  • Yonemoto, Naohiro
  • Yu, Chuanhua Sergeevich
  • Zastrozhin, Mikhail Sergeevich
  • Zhang, Zhi-Jiang R
  • Zimsen, Stephanie R
  • Resnikoff, Serge
  • Vos, Theo

publication date

  • February 2021