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

GBD 2019 Blindness and Vision Impairment Collaborators; Hai Quang Pham; Meseret Derbew Molla; Himal Kandel; Colm McAlinden; Konrad Pesudovs; Vision Loss Expert Group of the Global Burden of Disease Study

doi:10.1016/S2214-109X(20)30489-7

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

GBD 2019 Blindness and Vision Impairment Collaborators, Hai Quang Pham, Meseret Derbew Molla, Himal Kandel, Colm McAlinden, Konrad Pesudovs, Vision Loss Expert Group of the Global Burden of Disease Study

Research output: Contribution to journal › Article › peer-review

2524 Citations (Scopus)

15 Downloads (Pure)

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.

Original language	English
Pages (from-to)	e144-e160
Number of pages	17
Journal	The Lancet Global Health
Volume	9
Issue number	2
DOIs	https://doi.org/10.1016/S2214-109X(20)30489-7
Publication status	Published - Feb 2021
Externally published	Yes

Keywords

Global Burden of Disease
Blindness
Vision impairment
Right to Sight

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GBD 2019 Blindness and Vision Impairment Collaborators, Pham, H. Q., Molla, M. D., Kandel, H., McAlinden, C., Pesudovs, K., & Vision Loss Expert Group of the Global Burden of Disease Study (2021). 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. The Lancet Global Health, 9(2), e144-e160. https://doi.org/10.1016/S2214-109X(20)30489-7

GBD 2019 Blindness and Vision Impairment Collaborators ; Pham, Hai Quang ; Molla, Meseret Derbew et al. / 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. In: The Lancet Global Health. 2021 ; Vol. 9, No. 2. pp. e144-e160.

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title = "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",

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 Th{\'e}a, The Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.",

keywords = "Global Burden of Disease, Blindness, Vision impairment, Right to Sight",

author = "{GBD 2019 Blindness and Vision Impairment Collaborators} and Steinmetz, {Jaimie D.} and Bourne, {Rupert R.A.} and Mete Saylan and Mersha, {Abera M.} and Weldemariam, {Abrha Hailay} and Wondmeneh, {Temesgen Gebeyehu} and Sreeramareddy, {Chandrashekhar T.} and Marina Pinheiro and Mehdi Yaseri and Chuanhua Yu and Zastrozhin, {Mikhail Sergeevich} and Anasthasia Zastrozhina and Zhang, {Zhi Jiang} and Zimsen, {Stephanie R.M.} and Naohiro Yonemoto and Tsegaye, {Gebiyaw Wudie} and Vu, {Giang Thu} and Avina Vongpradith and Renzaho, {Andre M.N.} and Sorrie, {Muluken Bekele} and Shaheen, {Amira A.} and Shiferaw, {Wondimeneh Shibabaw} and Skryabin, {Valentin Yurievich} and Skryabina, {Anna Aleksandrovna} and Saya, {Ganesh Kumar} and Vafa Rahimi-Movaghar and Mika Shigematsu and Sahraian, {Mohammad Ali} and Homa Naderifar and Siamak Sabour and Priya Rathi and Brijesh Sathian and Miller, {Ted R.} and Aziz Rezapour and Lal Rawal and Pham, {Hai Quang} and Utsav Parekh and Vivek Podder and Onwujekwe, {Obinna E.} and Maja Pasovic and Nikita Otstavnov and Hadush Negash and Shrikant Pawar and Naimzada, {Mukhammad David} and {Al Montasir}, Ahmed and Ogbo, {Felix Akpojene} and Owolabi, {Mayowa O.} and Keyvan Pakshir and Yousef Mohammad and Moni, {Mohammad Ali} and Virginia Nunez-Samudio and Mulaw, {Getahun Fentaw} and Muhammad Naveed and Shokofeh Maleki and Michalek, {Irmina Maria} and Sanjeev Misra and Swamy, {Sreenivas Narasimha} and Mohammed, {Jemal Abdu} and Seth Flaxman and Park, {Eun Cheol} and Briant, {Paul Svitil} and Meles, {Gebrekiros Gebremichael} and Khezar Hayat and Iv{\'a}n Landires and Kim, {Gyu Ri} and Xuefeng Liu and LeGrand, {Kate E.} and Taylor, {Hugh R.} and Kunjathur, {Shilpashree Madhava} and Khoja, {Tawfik Ahmed Muthafer} and Bicer, {Burcu Kucuk} and Rovshan Khalilov and Abdiwahab Hashi and Kayode, {Gbenga A.} and Carneiro, {Vera L.A.} and Taras Kavetskyy and Soewarta Kosen and Vaman Kulkarni and Ramesh Holla and Rohollah Kalhor and Shubha Jayaram and Islam, {Sheikh Mohammed Shariful} and Gilani, {Syed Amir} and Sharareh Eskandarieh and Molla, {Meseret Derbew} and Ramaiah Itumalla and Farshad Farzadfar and Congdon, {Nathan G.} and Elhabashy, {Hala Rashad} and Rajesh Elayedath and Couto, {Rosa A.S.} and Nikolaos Dervenis and Cromwell, {Elizabeth A.} and Dahlawi, {Saad M.A.} and Serge Resnikoff and Casson, {Robert James} and Amir Abdoli and Choi, {Jee Young Jasmine} and {Dos Santos}, {Florentino Luciano Caetano} and Abrha, {Woldu Aberhe} and Nagaraja, {Sharath Burugina} and Ahmed Abualhasan and Adal, {Tadele Girum} and Aregawi, {Brhane Berhe} and Mahya Beheshti and Eman Abu-Gharbieh and Ashkan Afshin and Hamid Ahmadieh and Alemzadeh, {Sayyed Amirpooya} and Alessandro Arrigo and Atnafu, {Desta Debalkie} and Charlie Ashbaugh and Elham Ashrafi and Wondu Alemayehu and Alfaar, {Ahmed Samir} and Vahid Alipour and Anbesu, {Etsay Woldu} and Sofia Androudi and Jalal Arabloo and Aries Arditi and Eleni Bagli and Baig, {Atif Amin} and B{\"a}rnighausen, {Till Winfried} and Parodi, {Maurizio Battaglia} and Bhagavathula, {Akshaya Srikanth} and Nikha Bhardwaj and Pankaj Bhardwaj and Krittika Bhattacharyya and Ali Bijani and Mukharram Bikbov and Michele Bottone and Tasanee Braithwaite and Bron, {Alain M.} and Butt, {Zahid A.} and Cheng, {Ching Yu} and Chu, {Dinh Toi} and Cicinelli, {Maria Vittoria} and Coelho, {Jo{\~a}o M.} and Xiaochen Dai and Reza Dana and Lalit Dandona and Rakhi Dandona and {Del Monte}, {Monte A.} and Deva, {Jenny P.} and Daniel Diaz and Shirin Djalalinia and Dreer, {Laura E.} and Ehrlich, {Joshua R.} and Ellwein, {Leon B.} and Emamian, {Mohammad Hassan} and Fernandes, {Arthur G.} and Florian Fischer and Friedman, {David S.} and Furtado, {Jo{\~a}o M.} and Shilpa Gaidhane and Gus Gazzard and Berhe Gebremichael and Ronnie George and Ahmad Ghashghaee and Mahaveer Golechha and Samer Hamidi and Hammond, {Billy Randall} and Hartnett, {Mary Elizabeth R.} and Hartono, {Risky Kusuma} and Hay, {Simon I.} and Golnaz Heidari and Ho, {Hung Chak} and Mowafa Househ and Ibitoye, {Segun Emmanuel} and Ilic, {Irena M.} and Huang, {John J.} and Ilic, {Milena D.} and Ingram, {April D.} and Irvani, {Seyed Sina Naghibi} and Jha, {Ravi Prakash} and Rim Kahloun and Himal Kandel and Kasa, {Ayele Semachew} and Kempen, {John H.} and Moncef Khairallah and Khan, {Ejaz Ahmad} and Khanna, {Rohit C.} and Khatib, {Mahalaqua Nazli} and Kim, {Judy E.} and Kim, {Yun Jin} and Adnan Kisa and Sezer Kisa and Ai Koyanagi and Kurmi, {Om P.} and Lansingh, {Van Charles} and Leasher, {Janet L.} and Nicolas Leveziel and Hans Limburg and Navid Manafi and Kaweh Mansouri and Colm McAlinden and Mohammadi, {Seyed Farzad} and Mokdad, {Ali H.} and Morse, {Alan R.} and Mehdi Naderi and Naidoo, {Kovin S.} and Vinay Nangia and Nguyen, {Huong Lan Thi} and Kolawole Ogundimu and Olagunju, {Andrew T.} and Songhomitra Panda-Jonas and Konrad Pesudovs and Tunde Peto and {Ur Rahman}, {Mohammad Hifz} and Ramulu, {Pradeep Y.} and Rawaf, {David Laith} and Salman Rawaf and Nickolas Reinig and Robin, {Alan L.} and Luca Rossetti and Sare Safi and Amirhossein Sahebkar and Samy, {Abdallah M.} and Serle, {Janet B.} and Shaikh, {Masood Ali} and Shen, {Tueng T.} and Kenji Shibuya and Shin, {Jae Il} and Silva, {Juan Carlos} and Alexander Silvester and Singh, {Jasvinder A.} and Deepika Singhal and Sitorus, {Rita S.} and Eirini Skiadaresi and Amin Soheili and Sousa, {Ra{\'u}l A.R.C.} and Dwight Stambolian and Tadesse, {Eyayou Girma} and Nina Tahhan and Tareque, {Md Ismail} and Fotis Topouzis and Tran, {Bach Xuan} and Tsilimbaris, {Miltiadis K.} and Rohit Varma and Gianni Virgili and Ningli Wang and Wang, {Ya Xing} and West, {Sheila K.} and Wong, {Tien Y.} and Jonas, {Jost B.} and Theo Vos and {Vision Loss Expert Group of the Global Burden of Disease Study}",

year = "2021",

month = feb,

doi = "10.1016/S2214-109X(20)30489-7",

language = "English",

volume = "9",

pages = "e144--e160",

journal = "The Lancet Global Health",

issn = "2214-109X",

publisher = "Elsevier BV",

number = "2",

}

GBD 2019 Blindness and Vision Impairment Collaborators, Pham, HQ, Molla, MD, Kandel, H, McAlinden, C, Pesudovs, K & Vision Loss Expert Group of the Global Burden of Disease Study 2021, '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', The Lancet Global Health, vol. 9, no. 2, pp. e144-e160. https://doi.org/10.1016/S2214-109X(20)30489-7

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. / GBD 2019 Blindness and Vision Impairment Collaborators; Pham, Hai Quang; Molla, Meseret Derbew et al.
In: The Lancet Global Health, Vol. 9, No. 2, 02.2021, p. e144-e160.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - 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

T2 - an analysis for the Global Burden of Disease Study

AU - GBD 2019 Blindness and Vision Impairment Collaborators

AU - Steinmetz, Jaimie D.

AU - Bourne, Rupert R.A.

AU - Saylan, Mete

AU - Mersha, Abera M.

AU - Weldemariam, Abrha Hailay

AU - Wondmeneh, Temesgen Gebeyehu

AU - Sreeramareddy, Chandrashekhar T.

AU - Pinheiro, Marina

AU - Yaseri, Mehdi

AU - Yu, Chuanhua

AU - Zastrozhin, Mikhail Sergeevich

AU - Zastrozhina, Anasthasia

AU - Zhang, Zhi Jiang

AU - Zimsen, Stephanie R.M.

AU - Yonemoto, Naohiro

AU - Tsegaye, Gebiyaw Wudie

AU - Vu, Giang Thu

AU - Vongpradith, Avina

AU - Renzaho, Andre M.N.

AU - Sorrie, Muluken Bekele

AU - Shaheen, Amira A.

AU - Shiferaw, Wondimeneh Shibabaw

AU - Skryabin, Valentin Yurievich

AU - Skryabina, Anna Aleksandrovna

AU - Saya, Ganesh Kumar

AU - Rahimi-Movaghar, Vafa

AU - Shigematsu, Mika

AU - Sahraian, Mohammad Ali

AU - Naderifar, Homa

AU - Sabour, Siamak

AU - Rathi, Priya

AU - Sathian, Brijesh

AU - Miller, Ted R.

AU - Rezapour, Aziz

AU - Rawal, Lal

AU - Pham, Hai Quang

AU - Parekh, Utsav

AU - Podder, Vivek

AU - Onwujekwe, Obinna E.

AU - Pasovic, Maja

AU - Otstavnov, Nikita

AU - Negash, Hadush

AU - Pawar, Shrikant

AU - Naimzada, Mukhammad David

AU - Al Montasir, Ahmed

AU - Ogbo, Felix Akpojene

AU - Owolabi, Mayowa O.

AU - Pakshir, Keyvan

AU - Mohammad, Yousef

AU - Moni, Mohammad Ali

AU - Nunez-Samudio, Virginia

AU - Mulaw, Getahun Fentaw

AU - Naveed, Muhammad

AU - Maleki, Shokofeh

AU - Michalek, Irmina Maria

AU - Misra, Sanjeev

AU - Swamy, Sreenivas Narasimha

AU - Mohammed, Jemal Abdu

AU - Flaxman, Seth

AU - Park, Eun Cheol

AU - Briant, Paul Svitil

AU - Meles, Gebrekiros Gebremichael

AU - Hayat, Khezar

AU - Landires, Iván

AU - Kim, Gyu Ri

AU - Liu, Xuefeng

AU - LeGrand, Kate E.

AU - Taylor, Hugh R.

AU - Kunjathur, Shilpashree Madhava

AU - Khoja, Tawfik Ahmed Muthafer

AU - Bicer, Burcu Kucuk

AU - Khalilov, Rovshan

AU - Hashi, Abdiwahab

AU - Kayode, Gbenga A.

AU - Carneiro, Vera L.A.

AU - Kavetskyy, Taras

AU - Kosen, Soewarta

AU - Kulkarni, Vaman

AU - Holla, Ramesh

AU - Kalhor, Rohollah

AU - Jayaram, Shubha

AU - Islam, Sheikh Mohammed Shariful

AU - Gilani, Syed Amir

AU - Eskandarieh, Sharareh

AU - Molla, Meseret Derbew

AU - Itumalla, Ramaiah

AU - Farzadfar, Farshad

AU - Congdon, Nathan G.

AU - Elhabashy, Hala Rashad

AU - Elayedath, Rajesh

AU - Couto, Rosa A.S.

AU - Dervenis, Nikolaos

AU - Cromwell, Elizabeth A.

AU - Dahlawi, Saad M.A.

AU - Resnikoff, Serge

AU - Casson, Robert James

AU - Abdoli, Amir

AU - Choi, Jee Young Jasmine

AU - Dos Santos, Florentino Luciano Caetano

AU - Abrha, Woldu Aberhe

AU - Nagaraja, Sharath Burugina

AU - Abualhasan, Ahmed

AU - Adal, Tadele Girum

AU - Aregawi, Brhane Berhe

AU - Beheshti, Mahya

AU - Abu-Gharbieh, Eman

AU - Afshin, Ashkan

AU - Ahmadieh, Hamid

AU - Alemzadeh, Sayyed Amirpooya

AU - Arrigo, Alessandro

AU - Atnafu, Desta Debalkie

AU - Ashbaugh, Charlie

AU - Ashrafi, Elham

AU - Alemayehu, Wondu

AU - Alfaar, Ahmed Samir

AU - Alipour, Vahid

AU - Anbesu, Etsay Woldu

AU - Androudi, Sofia

AU - Arabloo, Jalal

AU - Arditi, Aries

AU - Bagli, Eleni

AU - Baig, Atif Amin

AU - Bärnighausen, Till Winfried

AU - Parodi, Maurizio Battaglia

AU - Bhagavathula, Akshaya Srikanth

AU - Bhardwaj, Nikha

AU - Bhardwaj, Pankaj

AU - Bhattacharyya, Krittika

AU - Bijani, Ali

AU - Bikbov, Mukharram

AU - Bottone, Michele

AU - Braithwaite, Tasanee

AU - Bron, Alain M.

AU - Butt, Zahid A.

AU - Cheng, Ching Yu

AU - Chu, Dinh Toi

AU - Cicinelli, Maria Vittoria

AU - Coelho, João M.

AU - Dai, Xiaochen

AU - Dana, Reza

AU - Dandona, Lalit

AU - Dandona, Rakhi

AU - Del Monte, Monte A.

AU - Deva, Jenny P.

AU - Diaz, Daniel

AU - Djalalinia, Shirin

AU - Dreer, Laura E.

AU - Ehrlich, Joshua R.

AU - Ellwein, Leon B.

AU - Emamian, Mohammad Hassan

AU - Fernandes, Arthur G.

AU - Fischer, Florian

AU - Friedman, David S.

AU - Furtado, João M.

AU - Gaidhane, Shilpa

AU - Gazzard, Gus

AU - Gebremichael, Berhe

AU - George, Ronnie

AU - Ghashghaee, Ahmad

AU - Golechha, Mahaveer

AU - Hamidi, Samer

AU - Hammond, Billy Randall

AU - Hartnett, Mary Elizabeth R.

AU - Hartono, Risky Kusuma

AU - Hay, Simon I.

AU - Heidari, Golnaz

AU - Ho, Hung Chak

AU - Househ, Mowafa

AU - Ibitoye, Segun Emmanuel

AU - Ilic, Irena M.

AU - Huang, John J.

AU - Ilic, Milena D.

AU - Ingram, April D.

AU - Irvani, Seyed Sina Naghibi

AU - Jha, Ravi Prakash

AU - Kahloun, Rim

AU - Kandel, Himal

AU - Kasa, Ayele Semachew

AU - Kempen, John H.

AU - Khairallah, Moncef

AU - Khan, Ejaz Ahmad

AU - Khanna, Rohit C.

AU - Khatib, Mahalaqua Nazli

AU - Kim, Judy E.

AU - Kim, Yun Jin

AU - Kisa, Adnan

AU - Kisa, Sezer

AU - Koyanagi, Ai

AU - Kurmi, Om P.

AU - Lansingh, Van Charles

AU - Leasher, Janet L.

AU - Leveziel, Nicolas

AU - Limburg, Hans

AU - Manafi, Navid

AU - Mansouri, Kaweh

AU - McAlinden, Colm

AU - Mohammadi, Seyed Farzad

AU - Mokdad, Ali H.

AU - Morse, Alan R.

AU - Naderi, Mehdi

AU - Naidoo, Kovin S.

AU - Nangia, Vinay

AU - Nguyen, Huong Lan Thi

AU - Ogundimu, Kolawole

AU - Olagunju, Andrew T.

AU - Panda-Jonas, Songhomitra

AU - Pesudovs, Konrad

AU - Peto, Tunde

AU - Ur Rahman, Mohammad Hifz

AU - Ramulu, Pradeep Y.

AU - Rawaf, David Laith

AU - Rawaf, Salman

AU - Reinig, Nickolas

AU - Robin, Alan L.

AU - Rossetti, Luca

AU - Safi, Sare

AU - Sahebkar, Amirhossein

AU - Samy, Abdallah M.

AU - Serle, Janet B.

AU - Shaikh, Masood Ali

AU - Shen, Tueng T.

AU - Shibuya, Kenji

AU - Shin, Jae Il

AU - Silva, Juan Carlos

AU - Silvester, Alexander

AU - Singh, Jasvinder A.

AU - Singhal, Deepika

AU - Sitorus, Rita S.

AU - Skiadaresi, Eirini

AU - Soheili, Amin

AU - Sousa, Raúl A.R.C.

AU - Stambolian, Dwight

AU - Tadesse, Eyayou Girma

AU - Tahhan, Nina

AU - Tareque, Md Ismail

AU - Topouzis, Fotis

AU - Tran, Bach Xuan

AU - Tsilimbaris, Miltiadis K.

AU - Varma, Rohit

AU - Virgili, Gianni

AU - Wang, Ningli

AU - Wang, Ya Xing

AU - West, Sheila K.

AU - Wong, Tien Y.

AU - Jonas, Jost B.

AU - Vos, Theo

AU - Vision Loss Expert Group of the Global Burden of Disease Study

PY - 2021/2

Y1 - 2021/2

N2 - 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.

AB - 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.

KW - Global Burden of Disease

KW - Blindness

KW - Vision impairment

KW - Right to Sight

UR - http://www.scopus.com/inward/record.url?scp=85099179366&partnerID=8YFLogxK

U2 - 10.1016/S2214-109X(20)30489-7

DO - 10.1016/S2214-109X(20)30489-7

M3 - Article

C2 - 33275949

AN - SCOPUS:85099179366

SN - 2214-109X

VL - 9

SP - e144-e160

JO - The Lancet Global Health

JF - The Lancet Global Health

IS - 2

ER -

GBD 2019 Blindness and Vision Impairment Collaborators, Pham HQ, Molla MD, Kandel H, McAlinden C, Pesudovs K et al. 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. The Lancet Global Health. 2021 Feb;9(2):e144-e160. doi: 10.1016/S2214-109X(20)30489-7

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

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