June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
The economic burden of vision loss falls disproportionately on inhabitants of low-income nations
Author Affiliations & Notes
  • Christopher R Fortenbach
    Ophthalmology and Visual Sciences, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
  • Michael David Abramoff
    Ophthalmology and Visual Sciences, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
    Digital Diagnostics Inc, Coralville, Iowa, United States
  • Footnotes
    Commercial Relationships   Christopher Fortenbach None; Michael Abramoff Digital Diagnostics, Code C (Consultant/Contractor), University of Iowa, Department of Veterans Affairs, Digital Diagnostics, Code I (Personal Financial Interest), Digital Diagnostics, Code S (non-remunerative)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2795 – A0125. doi:
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      Christopher R Fortenbach, Michael David Abramoff; The economic burden of vision loss falls disproportionately on inhabitants of low-income nations. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2795 – A0125.

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

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Abstract

Purpose : Over 200 million people worldwide suffer from moderate-to-severe vision impairment (MSVI) with an estimated global cost of hundreds of billions of US dollars per year in treatment, rehabilitation, and lost income. In absolute terms, most of the cost occurs in high income countries. However, this absolute cost does not fully convey the real-world impact of lost income, for example whether an individual’s MSVI implies poverty, as poverty levels differ dramatically across countries. As no suitable measures exist to compare such normalized cost and impact, we propose a new metric by which to estimate and compare the impact of lost income due to MSVI globally.

Methods : Gross national income data per capita (adjusted to purchasing power parity in current international $, GNI-PPP) for 2020 as well as national poverty thresholds (in GNI PPP) were obtained from the World Bank for all available countries (https://data.worldbank.org/indicator/NY.GNP.PCAP.PP.CD). Variance data were not available. MSVI was assumed to carry a 30% average loss of income at the national level (Eckert et al., 2015; Marques et al., 2021). The poverty threshold for the nation was then expressed as a percentage of the adjusted income (Blindness Poverty Risk or BPR).

Results : Among the Global Burden of Disease super regions, high-income countries are home to approximately ten percent of the world’s MSVI population but account for thirty percent of the lost income. When evaluating the proportion of income required to exceed the poverty threshold however, lower-income nations bore much of the global burden. The BPR was low in many of the countries with the greatest absolute losses in GNI-PPP due to MSVI (e.g., 19% in the United States), meaning that these countries had a lower proportion of income required to meet the poverty threshold. Central (51%) and East (58%) Sub-Saharan Africa, and Oceania (49%) had the most with Burundi (135%), the Central African Republic (102%), and the Democratic Republic of Congo (94%) requiring the greatest proportion of income to meet the poverty threshold.

Conclusions : Despite higher-income countries having the greatest absolute amount of lost earnings, the risk of poverty due to MSVI is greatest in lower-income countries. These first estimates provide a quantitative measure of the impact of lost income due to MSVI across countries where income and cost of living can vary dramatically.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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