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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)
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.
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.
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).
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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