Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study

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Abstract

BACKGROUND: To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990-2020, and forecasts for 2050. METHODS: We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. Only studies with samples representative of the population and with clearly defined visual acuity testing protocols were included. We fitted hierarchical models to estimate 2020 prevalence (with 95% uncertainty intervals [UIs]) of mild vision impairment (presenting visual acuity ≥6/18 and <6/12), moderate and severe vision impairment (<6/18 to 3/60), and blindness (<3/60 or less than 10° visual field around central fixation); and vision impairment from uncorrected presbyopia (presenting near vision <N6 or <N8 at 40 cm where best-corrected distance visual acuity is ≥6/12). We forecast estimates of vision loss up to 2050. FINDINGS: In 2020, an estimated 43·3 million (95% UI 37·6-48·4) people were blind, of whom 23·9 million (55%; 20·8-26·8) were estimated to be female. We estimated 295 million (267-325) people to have moderate and severe vision impairment, of whom 163 million (55%; 147-179) were female; 258 million (233-285) to have mild vision impairment, of whom 142 million (55%; 128-157) were female; and 510 million (371-667) to have visual impairment from uncorrected presbyopia, of whom 280 million (55%; 205-365) were female. Globally, between 1990 and 2020, among adults aged 50 years or older, age-standardised prevalence of blindness decreased by 28·5% (-29·4 to -27·7) and prevalence of mild vision impairment decreased slightly (-0·3%, -0·8 to -0·2), whereas prevalence of moderate and severe vision impairment increased slightly (2·5%, 1·9 to 3·2; insufficient data were available to calculate this statistic for vision impairment from uncorrected presbyopia). In this period, the number of people who were blind increased by 50·6% (47·8 to 53·4) and the number with moderate and severe vision impairment increased by 91·7% (87·6 to 95·8). By 2050, we predict 61·0 million (52·9 to 69·3) people will be blind, 474 million (428 to 518) will have moderate and severe vision impairment, 360 million (322 to 400) will have mild vision impairment, and 866 million (629 to 1150) will have uncorrected presbyopia. INTERPRETATION: Age-adjusted prevalence of blindness has reduced over the past three decades, yet due to population growth, progress is not keeping pace with needs. We face enormous challenges in avoiding vision impairment as the global population grows and ages. FUNDING: Brien Holden Vision Institute, Fondation Thea, Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.

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The record

Venue

The Lancet Global Health

Topic

Ophthalmology and Visual Impairment Studies

Field

Medicine

Canadian institutions

University of ManitobaMcMaster UniversityUniversity of Waterloo

Funders

Student Research Committee, Tabriz University of Medical SciencesMoorfields Eye CharityJahrom University of Medical SciencesSamara UniversityUniversity of ThessalyUniversity of GondarUniversidad Nacional Autónoma de MéxicoUniversidade de São PauloHaramaya UniversityBabol University of Medical SciencesResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesUniversidad Autónoma de SinaloaUniversity of WaterlooSightsavers InternationalMinistry of Health and Medical EducationBundesministerium für Bildung und ForschungSingapore Eye Research InstituteUniversity of New South WalesUniversität HeidelbergUniversidade do PortoShahid Beheshti University of Medical SciencesĐại học Quốc gia Hà NộiPublic Health Foundation of IndiaIndian Council of Medical ResearchUniversity College LondonShahroud University of Medical SciencesUniversity of CalcuttaDuke-NUS Medical SchoolFred Hollows FoundationXiamen UniversityDebre Markos UniversityUniversiti Tunku Abdul RahmanAerie PharmaceuticalsResearch Management Centre, International Islamic University MalaysiaFight for SightIran University of Medical SciencesNational Eye InstituteNational Institute for Health and Care ResearchBrien Holden Vision InstituteUniversity of UtahInstitute for Health Metrics and EvaluationInternational Glaucoma AssociationFight for Sight UKNational Institutes of HealthAnglia Ruskin UniversityResearch to Prevent BlindnessImperial College LondonBausch and LombUniverzita Karlova v PrazeMoorfields Eye Hospital NHS Foundation TrustUnited Arab Emirates UniversityHarvard UniversityAlexander von Humboldt-StiftungBill and Melinda Gates FoundationUniversity of WashingtonUniversiti Sultan Zainal AbidinMiddlesex University

Keywords

Visual impairmentVisual acuityMedicinePopulationPresbyopiaOptometryOphthalmologyEnvironmental healthPsychiatry

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