June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Burden of Global Vision Loss Due to Uncorrected Refractive Error: Temporal and Regional Changes 2000-2020
Author Affiliations & Notes
  • Nathan G Congdon
    Centre for Public Health, Queen's University Belfast, Belfast, Belfast, United Kingdom
    ORBIS International, New York, New York, United States
  • Joshua R Ehrlich
    University of Michigan, Ann Arbor, Michigan, United States
  • Serge Resnikoff
    BHVI, Sydney, New South Wales, Australia
  • Jaimie D Steinmetz
    University of Washington, Seattle, Washington, United States
  • Paul S Briant
    University of Washington, Seattle, Washington, United States
  • Kovin Naidoo
    University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
  • Janet Leasher
    Nova Southeastern University, Fort Lauderdale, Florida, United States
  • Rohit Varma
    University of Southern California, Los Angeles, California, United States
  • Jost Jonas
    Ruprecht Karls Universitat Heidelberg, Heidelberg, Baden-Württemberg, Germany
  • John H Kempen
    Harvard University, Boston, Massachusetts, United States
  • Tasanee Braithwaite
    St Thomas' Hospital, London, London, United Kingdom
  • Hugh R Taylor
    The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
  • Theo Vos
    University of Washington, Seattle, Washington, United States
  • Rupert R A Bourne
    Anglia Ruskin University, Chelmsford, Essex, United Kingdom
  • Footnotes
    Commercial Relationships   Nathan Congdon, Belkin Laser (F); Joshua Ehrlich, None; Serge Resnikoff, None; Jaimie Steinmetz, None; Paul Briant, None; Kovin Naidoo, Essilor (E); Janet Leasher, None; Rohit Varma, None; Jost Jonas, None; John Kempen, None; Tasanee Braithwaite, None; Hugh Taylor, None; Theo Vos, None; Rupert Bourne, None
  • Footnotes
    Support  Brien Holden Vision Institute; Fondation Théa; Lions Clubs International Foundation; The Fred Hollows Foundation; Bill and Melinda Gates Foundation; Sightsavers; University of Heidelberg; Prof Congdon is supported by the Ulverscroft Foundation
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 2885. doi:
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      Nathan G Congdon, Joshua R Ehrlich, Serge Resnikoff, Jaimie D Steinmetz, Paul S Briant, Kovin Naidoo, Janet Leasher, Rohit Varma, Jost Jonas, John H Kempen, Tasanee Braithwaite, Hugh R Taylor, Theo Vos, Rupert R A Bourne; Burden of Global Vision Loss Due to Uncorrected Refractive Error: Temporal and Regional Changes 2000-2020. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2885.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : To update estimates of the global vision loss burden due to uncorrected refractive error (URE), presenting temporal change since the beginning of Vision 2020 and distribution by sex and region.

Methods : Data gathered from population-based surveys of eye disease from January, 1980, to October, 2018 were collated. 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) caused by URE, by age, sex, region, and year. Prevalence of near VI from uncorrected presbyopia, defined to avoid double counting individuals with both distance and near VI, was based on 25 studies.

Results : In 2020, 2.29 million (95% UI 1.79 to 2.80) people aged 50+ years were blind due to URE globally, and 86.1 million (74.2-101.0) had MSVI, 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% and 2.4% respectively during this time. 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. For MSVI, this ratio was 1.08:1.00 in 2020 and 1.06:1.00 in 2000. South Asia had the highest regional 50+ age-standardised URE blindness and MSVI rates in 2020 (blind: 0.33%, 0.26-0.40; MSVI: 10.3%; 8.82-12.1), and also the greatest reductions in age-standardised URE blindness between 2000 and 2020 (46.3%). In 2020, an estimated 419 million (295-562) people 50+ had near VI from uncorrected presbyopia, a 75.3% increase since 2000. Three-quarters of global near VI from presbyopia occurred in Asia (312 million, 217-418).

Conclusions : Raw prevalence of VI from URE grew due to population aging, even as age-standardised prevalence fell since 2000. The striking decline in age-adjusted URE blindness (compared to MSVI) suggests successful targeting of the most severe cases, such as prevention of aphakia with intra-ocular lenses. Further reduction in the burden of VI from URE can be realised by adding refractive services to universal health coverage and otherwise improving access. Focusing on the 50+ population provides an incomplete view of VI due to URE, which frequently affects younger persons. The very large burden of presbyopia and sparsity of available data underscore the need for more research on this condition.

This is a 2021 ARVO Annual Meeting abstract.


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