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

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
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.

More information

Type
Journal Article
Author
Bourne R
Steinmetz JD
Flaxman S
Briant PS
Taylor HR
Resnikoff S
Casson RJ
Abdoli A
Abu-Gharbieh E
Afshin A
Ahmadieh H
Akalu Y
Alamneh AA
Alemayehu W
Alfaar AS
Alipour V
Anbesu EW
Androudi S
Arabloo J
Arditi A
Asaad M
Bagli E
Baig AA
Bärnighausen TW
Battaglia Parodi M
Bhagavathula AS
Bhardwaj N
Bhardwaj P
Bhattacharyya K
Bijani A
Bikbov M
Bottone M
Braithwaite T
Bron AM
Butt ZA
Cheng C
Chu D
Cicinelli MV
Coelho JM
Dagnew B
Dai X
Dana R
Dandona L
Dandona R
Del Monte MA
Deva JP
Diaz D
Djalalinia S
Dreer LE
Ehrlich JR
Ellwein LB
Emamian MH
Fernandes AG
Fischer F
Friedman DS
Furtado JM
Gaidhane AM
Gaidhane S
Gazzard G
Gebremichael B
George R
Ghashghaee A
Golechha M
Hamidi S
Hammond BR
Hartnett MER
Hartono RK
Hay SI
Heidari G
Ho HC
Hoang CL
Househ M
Ibitoye SE
Ilic IM
Ilic MD
Ingram AD
Irvani SSN
Jha RP
Kahloun R
Kandel H
Kasa AS
Kempen JH
Keramati M
Khairallah M
Khan EA
Khanna RC
Khatib MN
Kim JE
Kim YJ
Kisa S
Kisa A
Koyanagi A
Kurmi OP
Lansingh VC
Leasher JL
Leveziel N
Limburg H
Majdan M
Manafi N
Mansouri K
McAlinden C
Mohammadi SF
Mohammadian-Hafshejani A
Mohammadpourhodki R
Mokdad AH
Moosavi D
Morse AR
Naderi M
Naidoo KS
Nangia V
Nguyen CT
Nguyen HLT
Ogundimu K
Olagunju AT
Ostroff SM
Panda-Jonas S
Pesudovs K
Peto T
Quazi Syed Z
Rahman MHU
Ramulu PY
Rawaf S
Rawaf DL
Reinig N
Robin AL
Rossetti L
Safi S
Sahebkar A
Samy AM
Saxena D
Serle JB
Shaikh MA
Shen TT
Shibuya K
Shin JI
Silva JC
Silvester A
Singh JA
Singhal D
Sitorus RS
Skiadaresi E
Skirbekk V
Soheili A
Sousa RARC
Spurlock EE
Stambolian D
Taddele BW
Tadesse EG
Tahhan N
Tareque MI
Topouzis F
Tran BX
Travillian RS
Tsilimbaris MK
Varma R
Virgili G
Wang YX
Wang N
West SK
Wong TY
Zaidi Z
Zewdie KA
Jonas JB
Vos T
Keywords
Year of Publication
2021
Journal
The Lancet Global Health
Volume
9
Issue
2
Number of Pages
e130-e143
Language
eng
ISSN Number
2214-109X
DOI
10.1016/s2214-109x(20)30425-3
Publication Language
eng