Effective Refractive Error Coverage in adults aged 50 years and older: the new global eyecare 2030 target endorsed by the World Health Assembly

Abstract

Purpose : In 2021, WHO Member States endorsed a global target of a 40-percentage-point increase in effective refractive error coverage (eREC) by 2030. eREC of a population is defined as "people who have their need for refractive error correction met (met need; ability to see 6/12 or better) among people who have need which may be met, undermet or unmet".This study updates global and regional estimates of eREC with additional population-based datasets added since the baseline eREC model summarised within the WHO's 'Report of the 2030 targets on effective coverage of eye care'.

Methods : The Vision Loss Expert Group analysed data from 776 489 participants of 228 population-based eye surveys (from 75 countries) conducted since 2000 to calculate eREC (met need/[met need + undermet need + unmet need]). A binary logistic regression model was used to estimate eREC by Global Burden of Disease (GBD) Study super region among adults aged 50 years and older.

Results : In 2023, distance eREC was 79.9% (95% CI 73.1–86.2) in the high-income super region; 59.35% (53.3–66.1) in North Africa and Middle East; 58.1% (52.3–65.7) in Latin America and the Caribbean; 45.0% (39.7–50.0) in Southeast Asia, East Asia; 44.9% (40.2–49.9) in Central Europe, Eastern Europe, and Central Asia, and Oceania; 32.6% (27.9–38.1) in South Asia; and 11.8% (6.5–15.3) in Sub-Saharan Africa. eREC was higher in men (41.9%; 36.4-46.0) than women (38.2%; 33.1-44.3). Lower eREC was found among adults aged 70 years and older (27.6%; 21.9-33.0) than in younger adults aged 50-69 years (43.6%, 38.5-49.1). Global distance eREC increased from 2000 to 2023 by 23.3%.

Conclusions : The addition of per-participant data from 59 additional population-based eye surveys since the original eREC analysis for the baseline report (169 studies from 61 countries) has increased the geographic coverage of the source data and lends more precision to eREC estimates by age, sex and region. Over the past 23 years, distance eREC has increased in each super region yet the WHO target still requires substantial improvements in quantity, quality and equity of refractive services.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.