Prevalence and causes of vision loss in Latin America and the Caribbean in 2015: magnitude, temporal trends and projections

OBJECTIVE: To estimate the prevalence and causes of blindness and vision impairment for distance and near in Latin America and the Caribbean (LAC) in 2015, and to forecast trends to 2020. METHODS: A meta-analysis from a global systematic review of cross-sectional, population-representative studies from published and unpublished sources from 1980 to 2014 included in the Global Vision Database. RESULTS: In 2015, across LAC, we estimate age-standardised prevalence to be 0.38% in all ages and 1.56% in those over age 50 for blindness, 2.06% in all ages and 7.86% in those over age 50 for moderate and severe vision impairment (MSVI), 1.89% in all ages and 6.93% in those over age 50 for mild vision impairment, and 39.59% in all ages and 45.27% in those over 50 for near vision impairment. We estimate that in 2015, 123.26 million persons were vision impaired; of those 2.34 million blind, 12.46 million with MSVI, 11.34 million mildly impaired and 97.12 million had near vision impairment. Cataract is the most common cause of blindness. Under- corrected refractive-error is the most common cause of vision impairment. CONCLUSIONS: Increasing granularity in prevalence estimates across all levels of vision loss suggest that one in five persons across LAC had some degree of vision loss in 2015. The absolute numbers of persons with vision impairment are increasing, while the age-standardised prevalence is decreasing. All countries should conduct epidemiologic studies to establish accurate national estimates and trends of vision impairment. Universal eye health services must be included in universal health coverage reforms to address fragmentation and segmentation of health care across the region.