Prevalence and causes of vision loss in Latin America and the Caribbean: 1990-2010

Objective: To present regional estimates of the magnitude and temporal trends in the prevalence and causes of blindness and moderate/severe visual impairment (MSVI) in Latin America and the Caribbean (LAC). Methods: A systematic review of cross-sectional population-representative data from published literature and unpublished studies was accessed and extracted to model the estimated prevalence of vision loss by region, country and globally, and the attributable cause fraction by region. Results: In the LAC combined region, estimated all-age both-gender age-standardised prevalence of blindness halved from 0.8% (0.6 to 1.1) in 1990 to 0.4% (0.4 to 0.6) in 2010 and MSVI decreased from 4.3% (3.1 to 5.3) to 2.7% (2.2 to 3.4). In the Caribbean, estimated all-age both-gender age-standardised prevalence of blindness decreased from 0.6% (0.4 to 0.8) in 1990 to 0.5% (0.4 to 0.6) in 2010 and MSVI decreased from 3.3% (1.3 to 4.1) in 1990 to 2.9% (1.8 to 3.8). In the LAC regions combined, there was an estimated 2.3 million blind and 14.1 million with MSVI in 2010. In 2010, cataract continues to contribute the largest proportion of blindness, except in Southern Latin America where macular degeneration is most common. In 2010, uncorrected refractive error was the most common cause of MSVI. Conclusions: While models suggest a decrease in age-standardised prevalence estimates, better data are needed to evaluate the disparities in the region. The increasing numbers of older people, coupled with the increase in vision loss associated with older age, will require further intervention to continue to reduce prevalence rates and to prevent a rise in absolute numbers of blind.