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

Bourne, R. and Steinmetz, J.D. and Flaxman, S. and Briant, P.S. and Taylor, H.R. and Resnikoff, S. and Casson, R.J. and Abdoli, A. and Abu-Gharbieh, E. and Afshin, A. and Ahmadieh, H. and Akalu, Y. and Alamneh, A.A. and Alemayehu, W. and Alfaar, A.S. and Alipour, V. and Anbesu, E.W. and Androudi, S. and Arabloo, J. and Arditi, A. and Asaad, M. and Bagli, E. and Baig, A.A. and Bärnighausen, T.W. and Parodi, M.B. and Bhagavathula, A.S. and Bhardwaj, N. and Bhardwaj, P. and Bhattacharyya, K. and Bijani, A. and Bikbov, M. and Bottone, M. and Braithwaite, T. and Bron, A.M. and Butt, Z.A. and Cheng, C.-Y. and Chu, D.-T. and Cicinelli, M.V. and Coelho, J.M. and Dagnew, B. and Dai, X. and Dana, R. and Dandona, L. and Dandona, R. and Del Monte, M.A. and Deva, J.P. and Diaz, D. and Djalalinia, S. and Dreer, L.E. and Ehrlich, J.R. and Ellwein, L.B. and Emamian, M.H. and Fernandes, A.G. and Fischer, F. and Friedman, D.S. and Furtado, J.M. and Gaidhane, A.M. and Gaidhane, S. and Gazzard, G. and Gebremichael, B. and George, R. and Ghashghaee, A. and Golechha, M. and Hamidi, S. and Hammond, B.R. and Hartnett, M.E.R. and Hartono, R.K. and Hay, S.I. and Heidari, G. and Ho, H.C. and Hoang, C.L. and Househ, M. and Ibitoye, S.E. and Ilic, I.M. and Ilic, M.D. and Ingram, A.D. and Irvani, S.S.N. and Jha, R.P. and Kahloun, R. and Kandel, H. and Kasa, A.S. and Kempen, J.H. and Keramati, M. and Khairallah, M. and Khan, E.A. and Khanna, R.C. and Khatib, M.N. and Kim, J.E. and Kim, Y.J. and Kisa, A. and Kisa, S. and Koyanagi, A. and Kurmi, O.P. and Lansingh, V.C. and Leasher, J.L. and Leveziel, N. and Limburg, H. and Majdan, M. and Manafi, N. and Mansouri, K. and McAlinden, C. and Mohammadi, S.F. and Mohammadian-Hafshejani, A. and Mohammadpourhodki, R. and Mokdad, A.H. and Moosavi, D. and Morse, A.R. and Naderi, M. and Naidoo, K.S. and Nangia, V. and Nguyen, C.T. and Nguyen, H.L.T. and Ogundimu, K. and Olagunju, A.T. and Ostroff, S.M. and Panda-Jones, S. and Pesudovs, K. and Peto, T. and Syed, Z.Q. and Ur Rahman, M.H. and Ramulu, P.Y. and Rawaf, D.L. and Rawaf, S. and Reinig, N. and Robin, A.L. and Rossetti, L. and Safi, S. and Sahebkar, A. and Samy, A.M. and Saxena, D. and Serle, J.B. and Shaikh, M.A. and Shen, T.T. and Shibuya, K. and Shin, J.I. and Silva, J.C. and Silvester, A. and Singh, J.A. and Singhal, D. and Sitorus, R.S. and Skiadaresi, E. and Skirbekk, V. and Soheili, A. and Sousa, R.A.R.C. and Spurlock, E.E. and Stambolian, D. and Taddele, B.W. and Tadesse, E.G. and Tahhan, N. and Tareque, Md.I. and Topouzis, F. and Tran, B.X. and Travillian, R.S. and Tsilimbaris, M.K. and Varma, R. and Virgili, G. and Wang, N. and Wang, Y.X. and West, S.K. and Wong, T.Y. and Zaidi, Z. and Zewdie, K.A. and Jonas, J.B. and Vos, T. and Blindness, GBD 2019 and Collaborators, Vision Impairment and of the Global Burden of Disease Study, Vision Loss Expert Group (2021) Trends in prevalence of blindness and distance and near vision impairment over 30 years: An analysis for the Global Burden of Disease Study. The Lancet Global Health, 9 (2). e130-e143.

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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. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

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