Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis

Flaxman, Seth R. and Bourne, Rupert R. A. and Resnikoff, Serge and Ackland, Peter and Braithwaite, Tasanee and Cicinelli, Maria V. and Das, Aditi and Jonas, Jost B. and Keeffe, Jill and Kempen, John H. and Leasher, Janet and Limburg, Hans and Naidoo, Kovin and Pesudovs, Konrad and Silvester, Alex and Stevens, Gretchen A. and Tahhan, Nina and Wong, Tien Y. and Taylor, Hugh R. and Arditi, Aries and Barkana, Yaniv and Bozkurt, Banu and Bron, Alain M. and Budenz, Donald and Cai, Feng and Casson, Robert and Chakravarthy, Usha and Choi, Jaewan and Congdon, Nathan and Dana, Reza and Dandona, Rakhi and Dandona, Lalit and Dekaris, Iva and Del Monte, Monte and Deva, Jenny and Dreer, Laura and Ellwein, Leon and Frazier, Marcela and Frick, Kevin and Friedman, David and Furtado, Joao and Gao, Hua and Gazzard, Gus and George, Ronnie and Gichuhi, Stephen and Gonzalez, Victor and Hammond, Billy and Hartnett, Mary E. and He, Minguang and Hejtmancik, James and Hirai, Flavio and Huang, John and Ingram, April and Javitt, Jonathan and Joslin, Charlotte and Khairallah, Moncef and Khanna, Rohit and Kim, Judy and Lambrou, George and Lansingh, Van Charles and Lanzetta, Paolo and Lim, Jennifer and Mansouri, Kaweh and Mathew, Anu and Morse, Alan and Munoz, Beatriz and Musch, David and Nangia, Vinay and Palaiou, Maria and Parodi, Maurizio B. and Pena, Fernando Y. and Peto, Tunde and Quigley, Harry and Raju, Murugesan and Ramulu, Pradeep and Rankin, Zane and Reza, Dana and Robin, Alan and Rossetti, Luca and Saaddine, Jinan and Sandar, Mya and Serle, Janet and Shen, Tueng and Shetty, Rajesh and Sieving, Pamela C. and Silva, Juan C. and Sitorus, Rita S. and Stambolian, Dwight and Tejedor, Jaime and Tielsch, James and Tsilimbaris, Miltiadis and van Meurs, Jan and Varma, Rohit and Virgili, Gianni and Wang, Ya Xing and Wang, Ning-Li and West, Sheila and Wiedemann, Peter and Wormald, Richard and Zheng, Yingfeng (2017) Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis. The Lancet Global Health, 5 (12). e1221-e1234. ISSN 2214-109X

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Background: Contemporary data on causes of vision impairment and blindness form an important basis for recommendations in public health policies. Refreshment of the Global Vision Database with recently published data sources permitted modeling of cause of vision loss data from 1990 to 2015, further disaggregation by cause, and forecasts to 2020. Methods: Published and unpublished population-based data on the causes of vision impairment and blindness from 1980 to 2015 were systematically analysed. A series of regression models were fit to estimate the proportion of moderate and severe vision impairment (MSVI; defined as presenting visual acuity <6/18 but ≥3/60 in the better eye) and blindness (presenting visual acuity <3/60 in the better eye) by cause by age, region, and year. Findings: Among the projected global population with MSVI (216.6 million; 80% uncertainty intervals [UI] 98.5-359.1), in 2015 the leading causes thereof are uncorrected refractive error (116.3 million; UI 49.4-202.1), cataract (52.6 million; UI 18.2-109.6), age-related macular degeneration (AMD; 8.4 million; UI 0.9-29.5), glaucoma (4.0 million; UI 0.6-13.3) and diabetic retinopathy (2.6 million; UI 0.2-9.9). In 2015, the leading global causes of blindness were cataract (12.6 million; UI 3.4-28.7) followed by uncorrected refractive error (7.4 million; UI 2.4-14.8) and glaucoma (2.9 million; UI 0.4-9.9), while by 2020, these numbers affected are anticipated to rise to 13.4 million, 8.0 million and 3.2 million, respectively. Cataract and uncorrected refractive error combined contributed to 55% of blindness and 77% of MSVI in adults aged 50 years and older in 2015. World regions varied markedly in the causes of blindness, with a relatively low prevalence of cataract and a relatively high prevalence of AMD as causes for vision loss in the High-income subregions. Blindness due to cataract and diabetic retinopathy was more common among women, while blindness due to glaucoma and corneal opacity was more common among men, with no gender difference related to AMD. Conclusions: The numbers of people affected by the common causes of vision loss have increased substantially as the population increases and ages. Preventable vision loss due to cataract and refractive error (reversible with surgery and spectacle correction respectively), continue to cause the majority of blindness and MSVI in adults aged 50+ years. A massive scale up of eye care provision to cope with the increasing numbers is needed if one is to address avoidable vision loss.

Item Type: Journal Article
Keywords: blindness, vision impairment
Faculty: ARCHIVED Faculty of Medical Science (until September 2018)
Depositing User: Ian Walker
Date Deposited: 27 Sep 2017 15:40
Last Modified: 10 Jun 2022 14:18

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