Causes of vision loss worldwide, 1990-2010: a systematic analysis.

Rupert R A Bourne, Gretchen A Stevens, Richard A White, Jennifer L Smith, Seth R Flaxman, Holly Price, Jost B Jonas, Jill Keeffe, Janet Leasher, Kovin Naidoo, Konrad Pesudovs, Serge Resnikoff, Hugh R Taylor

Journal: The Lancet. Global health 2015;1(6):e339-49

PMID: 25104599

Free Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

Data on causes of vision impairment and blindness are important for development of public health policies, but comprehensive analysis of change in prevalence over time is lacking.

METHODS

We did a systematic analysis of published and unpublished data on the causes of blindness (visual acuity in the better eye less than 3/60) and moderate and severe vision impairment ([MSVI] visual acuity in the better eye less than 6/18 but at least 3/60) from 1980 to 2012. We estimated the proportions of overall vision impairment attributable to cataract, glaucoma, macular degeneration, diabetic retinopathy, trachoma, and uncorrected refractive error in 1990-2010 by age, geographical region, and year.

FINDINGS

In 2010, 65% (95% uncertainty interval [UI] 61-68) of 32·4 million blind people and 76% (73-79) of 191 million people with MSVI worldwide had a preventable or treatable cause, compared with 68% (95% UI 65-70) of 31·8 million and 80% (78-83) of 172 million in 1990. Leading causes worldwide in 1990 and 2010 for blindness were cataract (39% and 33%, respectively), uncorrected refractive error (20% and 21%), and macular degeneration (5% and 7%), and for MSVI were uncorrected refractive error (51% and 53%), cataract (26% and 18%), and macular degeneration (2% and 3%). Causes of blindness varied substantially by region. Worldwide and in all regions more women than men were blind or had MSVI due to cataract and macular degeneration.

INTERPRETATION

The differences and temporal changes we found in causes of blindness and MSVI have implications for planning and resource allocation in eye care.

FUNDING

Bill & Melinda Gates Foundation, Fight for Sight, Fred Hollows Foundation, and Brien Holden Vision Institute.

Address: Vision and Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, UK. Electronic address: [email protected].; Department of Health Statistics and Information Systems, WHO, Geneva, Switzerland.; Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.; School of Computer Science and Heinz College, Carnegie Mellon University, Pittsburgh, PA, USA.; Vision and Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, UK.; Department of Ophthalmology, Universitätsmedizin, Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.; LV Prasad Eye Institute, Hyderabad, India.; College of Optometry, Nova Southeastern University, Fort-Lauderdale-Davie, FL, USA.; African Vision Research Institute, University of Kwazulu-Natal, South Africa; Brien Holden Vision Institute, Sydney, NSW, Australia.; NHMRC Centre for Clinical Eye Research, Flinders University, Adelaide, SA, Australia.; International Health and Development, Geneva, Switzerland.; Melbourne School of Public Health, University of Melbourne, Melbourne, VIC, Australia.

DOI: 10.1016/S2214-109X(13)70113-X

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MeSH Terms: Blindness, Cataract, Diabetic Retinopathy, Female, Glaucoma, Global Health, Humans, Macular Degeneration, Male, Trachoma, Vision Disorders