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Meta-Analysis
. 2024 Aug;38(11):2083-2101.
doi: 10.1038/s41433-024-03106-0. Epub 2024 Jul 4.

Global estimates on the number of people blind or visually impaired by Uncorrected Refractive Error: a meta-analysis from 2000 to 2020

Vision Loss Expert Group of the Global Burden of Disease Study; GBD 2019 Blindness and Vision Impairment Collaborators
Collaborators
Meta-Analysis

Global estimates on the number of people blind or visually impaired by Uncorrected Refractive Error: a meta-analysis from 2000 to 2020

Vision Loss Expert Group of the Global Burden of Disease Study et al. Eye (Lond). 2024 Aug.

Abstract

Background: Uncorrected refractive error (URE) is a readily treatable cause of visual impairment (VI). This study provides updated estimates of global and regional vision loss due to URE, presenting temporal change for VISION 2020 METHODS: Data from population-based eye disease surveys from 1980-2018 were collected. Hierarchical models estimated prevalence (95% uncertainty intervals [UI]) of blindness (presenting visual acuity (VA) < 3/60) and moderate-to-severe vision impairment (MSVI; 3/60 ≤ presenting VA < 6/18) caused by URE, stratified by age, sex, region, and year. Near VI prevalence from uncorrected presbyopia was defined as presenting near VA < N6/N8 at 40 cm when best-corrected distance (VA ≥ 6/12).

Results: In 2020, 3.7 million people (95%UI 3.10-4.29) were blind and 157 million (140-176) had MSVI due to URE, a 21.8% increase in blindness and 72.0% increase in MSVI since 2000. Age-standardised prevalence of URE blindness and MSVI decreased by 30.5% (30.7-30.3) and 2.4% (2.6-2.2) respectively during this time. In 2020, South Asia GBD super-region had the highest 50+ years age-standardised URE blindness (0.33% (0.26-0.40%)) and MSVI (10.3% (8.82-12.10%)) rates. The age-standardized ratio of women to men for URE blindness was 1.05:1.00 in 2020 and 1.03:1.00 in 2000. An estimated 419 million (295-562) people 50+ had near VI from uncorrected presbyopia, a +75.3% (74.6-76.0) increase from 2000 CONCLUSIONS: The number of cases of VI from URE substantively grew, even as age-standardised prevalence fell, since 2000, with a continued disproportionate burden by region and sex. Global population ageing will increase this burden, highlighting urgent need for novel approaches to refractive service delivery.

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Conflict of interest statement

GBD 2019 Blindness and Vision Impairment Collaborators: N J Adderley reports grants or contracts paid to their institution from the National Institute for Health and Care Research, UKRI Medical Research Council, Clinical Research Network West Midlands, and Action Against AMD. S Afzal reports support for the present manuscript from King Edward Medical University, Department of Community Medicine which provided study materials, research article, supporting staff and office for working on the manuscript; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from King Edward Medical University; participation on a Data Safety Monitoring Board or Advisory Board with the National Bioethics Committee Pakistan, King Edward Medical University Institutional Ethical Review Board and Ethical Review Committee in Board of Faculty, and Ethical Review Board Fatima Jinnah Medical University and Sir Ganga Ram Hospital; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, Pakistan Association of Medical Editors, Fellow of Faculty of Public Health Royal Colleges UK (FFPH), Society of Prevention, Advocacy And Research, King Edward Medical University. (SPARK), Member Pakistan Society of Infectious Diseases, Member Pakistan Society of Internal Medicine, Member Pakistan Society of Community Medicine and Public Health; other financial or non-financial interests in the Higher Education Commission of Pakistan as a member Research and Publications Committee, and Pakistan Medical and Dental Council as a member Journal Research Evaluation Committee; all outside the submitted work. O C Baltatu reports support for the present manuscript from National Council for Scientific and Technological Development (CNPq, 304224/2022-7), and Anima Institute - AI research professor fellowship; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, with the Health and Biotechnology Board at São José dos Campos Technology Park, and Afya – UNINOVAFAPI as Academic Ambassador; all outside the submitted work. T W Bärnighausen reports grants from the European Union (Horizon 2020 and EIT Health), German Research Foundation (DFG), US National Institutes of Health, German Ministry of Education and Research, Alexander von Humboldt Foundation, Else-Kröner-Fresenius - Foundation, Wellcome Trust, Bill & Melinda Gates Foundation, KfW, UNAIDS, and WHO; consulting fees from KfW on the OSCAR initiative in Vietnam; participation on a Data Safety Monitoring Board or Advisory Board with the NIH-funded study “Healthy Options”, Chair, Data Safety and Monitoring Board (DSMB), German National Committee on the “Future of Public Health Research and Education”, Chair of the scientific advisory board to the EDCTP Evaluation, Member of the UNAIDS Evaluation Expert Advisory Committee, National Institutes of Health Study Section Member on Population and Public Health Approaches to HIV/AIDS, US National Academies of Sciences, Engineering, and Medicine’s Committee for the “Evaluation of Human Resources for Health in the Republic of Rwanda under the President’s Emergency Plan for AIDS Relief”, and University of Pennsylvania Population Aging Research Center External Advisory Board Member; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, with the Global Health Hub Germany; all outside the submitted work. S Bhaskar reports grants or contracts from the Japan Society for the Promotion of Science (JSPS), JSPS International Fellowship, Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT), the Australian Academy of Science, Grant-in-Aid for Scientific Research (KAKENHI); leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with Rotary District 9675 as the District Chair of Diversity, Equity, and Inclusion; the Global Health & Migration Hub Community and the Global Health Hub Germany (Berlin, Germany) as the Chair and Manager; PLOS One, BMC Neurology, Frontiers In Neurology, Frontiers in Stroke, Frontiers in Public Health and BMC Medical Research Methodology as an Editorial Board Member, outside the submitted work. R Bourne reports support for the present manuscript to their institution from the World Health Organization (WHO), Brien Holden Vision Institute, Foundation Thea, Fred Hollows Foundation, Lions Clubs International Foundation; and grants or contracts to their institution from Sightsavers International and the University of Heidelberg. M Cenderadewi reports grants or contracts from James Cook University (International Research Training Program Scholarship for doctoral study), and support for attending meetings and travel from James Cook University; all outside the submitted work. N Congwon reports grants or contracts paid to their institute from the Wellcome Trust Investigator Award. X Dai and J D Steinmetz report support for the present manuscript from the Bill and Melinda Gates Foundation as payments to IHME for the GBD Study. A Dastridiou reports support for attending meetings and/or travel from THEA and ABBVIE; outside the submitted work. T Fricke reports a grant from the International Myopia Institute, and contracts from the Brien Holden Vision Institute and the Victorian Lions Foundation, all paid to the Australian College of Optometry; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from the University of Melbourne and UNSW Sydney; support from attending meetings and travel from the International Myopia Conference as a presenter, and UNSW Sydney as a PhD Candidate; all outside the submitted work. J M Furtado reports consulting fees from SightFirst and Pan American Health Organization; outside the submitted work. I M Ilic reports support for the present manuscript from Ministry of Education, Science and Technological development, Republic of Serbia (project No 175042, 2011-2023). S M S Islam reports grants from NHMRC and the Heart Foundation, outside the submitted work. F Ghassemi reports support for the present manuscript from medical writing. V K Gupta report grants or contracts from National Health and Medical Research Council (NHMRC), Australia, as payments to their institutions; all outside the submitted work. J H Kempen reports support for the present manuscript from Sight for Souls and Mass Eye and Ear Global Surgery Program. K Krishan reports non-financial support from UGC Centre of Advanced Study, CAS II, Department of Anthropology, Panjab University, Chandigarh, India, outside the submitted work. V C Lansingh reports consulting fees from HelpMeSee; and support for attending meetings and travel from HelpMeSee; all outside the submitted work. J L Leasher reports leadership or fiduciary role in other board, society, committee or advocacy group, unpaid as a member of the National Eye Institute National Eye Health Education Program planning committee; outside the submitted work. M Lee reports support for the present manuscript from the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2021R1I1A4A01057428) and Bio-convergence Technology Education Program through the Korea Institute for Advancement Technology (KIAT) funded by the Ministry of Trade, Industry and Energy (No. P0017805). K S Naidoo reports other financial support from OneSight EssilorLuxottica Foundation as an employee; outside the submitted work. M Saylan reports support for attending meetings and/or travel from Janssen Pharmaceuticals; outside the submitted work. J A Singh reports consulting fees from AstraZeneca, Crealta/Horizon, Medisys, Fidia, PK Med, Two labs Inc., Adept Field Solutions, Clinical Care options, Clearview healthcare partners, Putnam associates, Focus forward, Navigant consulting, Spherix, MedIQ, Jupiter Life Science, UBM LLC, Trio Health, Medscape, WebMD, Practice Point communications, and the National Institutes of Health and the American College of Rheumatology; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from the speaker’s bureau of Simply Speaking; support for attending meetings from OMERACT as a member of the steering committee; participation on an Advisory Committee with the FDA Arthritis Advisory Committee; leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid as a past steering committee member of the OMERACT, an international organization that develops measures for clinical trials and receives arms length funding from 12 pharmaceutical companies, Co-Chair of the Veterans Affairs Rheumatology Field Advisory Committee, and the editor and Director of the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis; stock or stock options in Atai Life Sciences, Kintara Therapeutics, Intelligent Biosolutions, Acumen Pharmaceutical, TPT Global Tech, Vaxart Pharmaceuticals, Atyu Biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics Inc., Seres Therapeutics, Tonix Pharmaceuticals Holding Corp., and Charlotte’s Web Holdings, Inc, as well as previously owned stock options in Amarin, Viking and Moderna Pharmaceuticals; outside the submitted work. Y S Samodra reports grants or contracts from Taipei Medical University; and other financial or non-financial interests as the co-founder of Benang Merah Research Center, outside the submitted work. N Tahhan reports support for attending meetings and travel from the Brien Holden Foundation to the ISER Conference; outside the submitted work. Y Tan reports support for the present manuscript from the Department of Ophthalmology and the Hospital Central South University and Postdoctoral Station of Clinical Medicine, The Third Xiangya Hospital of Central South University. J H V Ticoalu reports other financial or non-financial support as a co-founder of Benang Merah Research Center; outside the submitted work.

Vision Loss Expert Group of the Global Burden of Disease Study: A Bron reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Théa. N Congdon reports grants or contracts from any entity from Welcome Trust and MRC; consulting fees from Belkin Vision; and support for attending meetings and/or travel from Singapore National Eye Center. M A Del Monte reports support for attending meetings and/or travel from the University of Michigan, and leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid as past president of Costenbader Society. T Fricke reports grants or contracts from any entity from Brien Holden Vision Institute, Victorian Lions Foundation, International Myopia Institute, and Australian government; and support for attending meetings and/or travel from International Myopia Institute. D Friedman reports leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, from Orbis International as member of board of governors. J M Furtado reports consulting fees from Pan American Health Organization and from Lions Club International Foundation. G Gazzard reports consulting fees from Alcon Laboratories, Inc; Allergan, Inc; BELKIN Vision LTD; Carl Zeiss Meditec; Elios; Genentech/Roche; Reichert; Théa and ViaLase; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Alcon Laboratories, Inc; BELKIN Vision Ltd; Carl Zeiss Meditec; Elios and Ellex; participation on a Data Safety Monitoring Board or Advisory Board with Alcon Laboratories, Inc; Allergan, Inc; BELKIN Vision Ltd; Carl Zeiss Meditec; Elios and Visufarma; and leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid with Glaucoma UK Medical Advisory Board and UK&Eire Glaucoma Society as president. M E Hartnett reports support for the present manuscript (e.g., funding, provision of study materials, medical writing, article processing charges, etc.) from Michael F. Marmor, M.D. Professor of Retinal Science and Disease as endowment to support salary; grants or contracts from any entity (from National Eye Institute R01 EY017011 and National Eye Institute R01 EY015130) as partial salary support; patents planned, issued or pending (WO2015123561A2 and WO2021062169A1); and leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid with Jack McGovern Coats’ Disease Foundation and as director of Women’s Eye Health and Macular Society Grant Review Chair. J H Kempen reports support for the present manuscript (e.g., funding, provision of study materials, medical writing, article processing charges, etc.) from Mass Eye and Ear Global Surgery Program (as support of salary). J E Kim reports consulting fees from Genentech/Roche, DORC, Notal Vision and Outlook Therapeutics (all as payment to J E Kim); participation on a Data Safety Monitoring Board or Advisory Board with Allergan, Amgen, Apellis, Bausch&Lomb, Clearside, Coherus, Novartis and Regeneron (all as participation on advisory board); leadership or fiduciary role in other borad, society, committee or advocacy group, paid or unpaid, with AAO, APRIS, ASRS, Macular Society and NAEVR/AEVR (all unpaid); and receipt of equipment, materials, drugs, medical writing, gifts or other services from Clearside and Genentech/Roche (both for medical writing). V C Lansingh reports consulting fees from HelpMeSee (as an employee); and support for attending meetings and/or travel from HelpMeSee (pay airfare and hotel). J Leasher reports leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid with National Eye Institute (as a member) and National Eye Health Education Program planning committee (unpaid). K S Naidoo reports other financial or non-financial interests from OneSight Essilor Luxottica Foundation as an employee of the non-profit foundation. M Nowak reports participation on a Data Safety Monitoring Board or Advisory Board with Vision Express Co. Poland as the chairman of medical advisory board of Vision Express Co. Poland. P Ramulu reports grants or contracts from National Institute of Health and Perfuse Therapeutics; and consulting fees from Alcon and W. L. Gore. F Topouzis reports grants or contracts from Théa, Omikron, Pfizer, Alcon, Abbvie and Bayer (all paid to Institution); consulting fees from Omikron, Théa and Bausch & Lomb (all paid to Topouzis); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Omikron (paid to Topouzis), Abbvie and Roche (both paid to Institute); and leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid with European Glaucoma Society (as president), Greek Glaucoma Society (as president) and Board of Governors, World Glaucoma Association (all unpaid).

Figures

Fig. 1
Fig. 1. Bar charts demonstrating the number of men and women with blindness and MSVI due to URE in 2000 and 2020 by seven World GBD super-regions and globally.
a indicates numbers for MSVI and b blindness. Note that scales (values should be multiplied by 1000) are not the same between charts, but rather serve to highlight the differences across the time period and sex differences within GBD super-regions.
Fig. 2
Fig. 2. Crude prevalence of blindness and MSVI due to URE by region and globally by age.
a Crude prevalence of blindness due to URE in 2020 by seven World GBD super regions by age. b Crude prevalence of MSVI due to URE in 2020 by seven World GBD super regions by age. c Crude prevalence of Blindness (red) and MSVI (cyan) due to URE in 2020 globally by age, with 95% UI indicated as shading.
Fig. 3
Fig. 3. Comparison of the number of men and women with near vision impairment due to uncorrected presbyopia in 2000 and 2020 by seven World GBD super regions, with Global total bottom right panel.
Note scales (values should be multiplied by 1000) are not the same between charts, but rather serve to highlight the differences across the time period and sex differences within GBD super regions.
See this image and copyright information in PMC

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