Global estimates on the number of people blind or visually impaired by Uncorrected Refractive Error: a meta-analysis from 2000 to 2020
Authors:   Vision Loss Expert Group of the Global Burden of Disease Study, Little Julie-Anne , Congdon Nathan G. , Resnikoff Serge , Braithwaite Tasanee , Leasher Janet , Naidoo Kovin , Fricke Tim , Tapply Ian , Fernandes Arthur G. , Cicinelli Maria Vittoria , Arrigo Alessandro , Leveziel Nicolas , Taylor Hugh R. , Sedighi Tabassom , Flaxman Seth , Parodi Maurizio Battaglia , Bikbov Mukkharram M. , Bron Alain , Cheng Ching-Yu , Del Monte Monte A. , Ehrlich Joshua R. , Ellwein Leon B. , Friedman David , Furtado João M. , Gazzard Gus , George Ronnie , Hartnett M. Elizabeth , Jonas Jost B. , Kahloun Rim , Kempen John H. , Khairallah Moncef , Khanna Rohit C. , Kim Judy E. , Lansingh Van Charles , Nangia Vinay , Nowak Michal , Pesudovs Konrad , Peto Tunde , Ramulu Pradeep , Topouzis Fotis , Tsilimbaris Mitiadis , Wang Ya Xing , Wang Ningli , Bourne Rupert R. A. ,   the GBD 2019 Blindness and Vision Impairment Collaborators, Little Julie-Anne , Congdon Nathan G. , Resnikoff Serge , Braithwaite Tasanee , Leasher Janet L. , Naidoo Kovin S. , Tahhan Nina , Fricke Timothy , Fernandes Arthur G. , Cicinelli Maria Vittoria , Arrigo Alessandro , Leveziel Nicolas , Briant Paul Svitil , Vos Theo , Flaxman Seth , Abate Yohannes Habtegiorgis , Dolatabadi Zahra Abbasi , Abdelmasseh Michael , Abdollahi Mohammad , Abebe Ayele Mamo , Abiodun Olumide , Aboagye Richard Gyan , Abrha Woldu Aberhe , Ali Hiwa Abubaker , Abu-Gharbieh Eman , Aburuz Salahdein , Adal Tadele Girum Girum , Adamu Lawan Hassan , Adderley Nicola J. , Addo Isaac Yeboah , Adekiya Tayo Alex , Adhikari Kishor , Adnani Qorinah Estiningtyas Sakilah , Afzal Saira , Aghamiri Shahin , Agodi Antonella , Agyemang-Duah Williams , Ahinkorah Bright Opoku , Ahmad Aqeel , Ahmadzadeh Hooman , Ahmed Ayman , Ahmed Haroon , Alahdab Fares , Albashtawy Mohammed , AlBataineh Mohammad T. , Alemu Tsegaye , Alfaar Ahmad Samir , Alhalaiqa Fadwa Alhalaiqa Naji , Alhassan Robert Kaba , Ali Abid , Ali Syed Shujait Shujait , Almidani Louay , Alzoubi Karem H. , Androudi Sofia , Anguita Rodrigo , Anil Abhishek , Anyasodor Anayochukwu Edward , Arabloo Jalal , Aravkin Aleksandr Y. , Areda Damelash , Asgedom Akeza Awealom , Ashemo Mubarek Yesse , Ashraf Tahira , Athari Seyyed Shamsadin , Atinafu Bantalem Tilaye Tilaye , Wahbi Atout Maha Moh’d , Atreya Alok , Ayatollahi Haleh , Azzam Ahmed Y. , Bagherieh Sara , Bai Ruhai , Baig Atif Amin , Bailey Freddie , Baltatu Ovidiu Constantin , Barati Shirin , Barchitta Martina , Bardhan Mainak , Bärnighausen Till Winfried , Barrow Amadou , Parodi Maurizio Battaglia , Bayileyegn Nebiyou Simegnew , Berhie Alemshet Yirga , Bhadra Abhishek , Bhagavathula Akshaya Srikanth Srikanth , Bhardwaj Pankaj , Bhaskar Sonu , Bhat Ajay Nagesh , Bhatti Gurjit Kaur , Bikbov Mukharram , Birck Marina G. , Bustanji Yasser , Butt Zahid A. , dos Santos Florentino Luciano Caetano , Carneiro Vera L. A. , Cenderadewi Muthia , Chanie Gashaw Sisay , Cherbuin Nicolas , Chu Dinh-Toi , Coberly Kaleb , Cruz-Martins Natália , Dadras Omid , Dai Xiaochen , Dandona Lalit , Dandona Rakhi , Dascalu Ana Maria , Dastiridou Anna , Dejenie Tadesse Asmamaw , Demeke Dessalegn , Dereje Diriba , Dervenis Nikolaos , Devanbu Vinoth Gnana Chellaiyan , Diaz Daniel , Diress Mengistie , Do Thanh Chi , Do Thao Huynh Phuong , Dziedzic Arkadiusz Marian , Edinur Hisham Atan , Ehrlich Joshua R. , Ekholuenetale Michael , Elhabashy Hala Rashad , Elhadi Muhammed , Emamian Mohammad Hassan , Emamverdi Mehdi , Etemadimanesh Azin , Fagbamigbe Adeniyi Francis , Farrokhpour Hossein , Fatehizadeh Ali , Feizkhah Alireza , Desideri Lorenzo Ferro , Fetensa Getahun , Fischer Florian , Forouhari Ali , Furtado João M. , Gadanya Muktar A. , Gaidhane Abhay Motiramji , Gandhi Aravind P. , Gebi Tilaye Gebru , Gebrehiwot Mesfin , Gebremeskel Gebreamlak Gebremedhn , Gela Yibeltal Yismaw , Yazdi Bardiya Ghaderi , Falavarjani Khalil Ghasemi , Ghassemi Fariba , Ghozy Sherief , Golchin Ali , Golechha Mahaveer , Goleij Pouya , Guan Shi-Yang , Gupta Sapna , Gupta Vivek Kumar , Haddadi Rasool , Haile Teklehaimanot Gereziher , Hammond Billy Randall , Harorani Mehdi , Hasaballah Ahmed I. , Hasan Ikramul , Hasani Hamidreza , Hassanian-Moghaddam Hossein , Heidari Golnaz , Heyi Demisu Zenbaba , Holla Ramesh , Hosseinzadeh Mehdi , Hu Chengxi , Huynh Hong-Han , Hwang Bing-Fang , Iavicoli Ivo , Ilic Irena M. , Immurana Mustapha , Islam Sheikh Mohammed Shariful , Jacob Louis , Jafarzadeh Abdollah , Jakovljevic Mihajlo , Janodia Manthan Dilipkumar , Jayapal Sathish Kumar , Jayaram Shubha , Jonas Jost B. , Joseph Nitin , Joshua Charity Ehimwenma , Kamath Sagarika , Kandel Himal , Karaye Ibraheem M. , Kasraei Hengameh , Kaup Soujanya , Kaur Harkiran , Kaur Navjot , Kayode Gbenga A. , Kempen John H. , Khader Yousef Saleh , Khajuria Himanshu , Khalilov Rovshan , Khan Ajmal , Khatatbeh Moawiah Mohammad , Khatib Mahalaqua Nazli , Kibret Biruk Getahun , Kim Yun Jin , Kisa Adnan , Kisa Sezer , Kosen Soewarta , Koyanagi Ai , Krishan Kewal , Bicer Burcu Kucuk , Kumar Nithin , Kutikuppala L. V. Simhachalam , Lahariya Chandrakant , Laksono Tri , Lal Dharmesh Kumar , Lansingh Van Charles , Lee Munjae , Lee Seung Won , Lee Wei-Chen , Lim Stephen S. , Liu Xuefeng , Maharaj Sandeep B. , Mahmoudi Alireza , Malhotra Kashish , Malik Ahmad Azam , Malik Iram , Mallhi Tauqeer Hussain , Mansouri Vahid , Marzo Roy Rillera , Maugeri Andrea , Meles Gebrekiros Gebremichael , Mersha Abera M. , Mestrovic Tomislav , Miller Ted R. , Mirzaei Mehdi , Misganaw Awoke , Misra Sanjeev , Mithra Prasanna , Mohammadi Soheil , Mohammadian-Hafshejani Abdollah , Mohammadzadeh Maryam , Mojiri-forushani Hoda , Mokdad Ali H. , Momeni-Moghaddam Hamed , Montazeri Fateme , Moradi Maryam , Mousavi Parsa , Murray Christopher J. L. , Naik Ganesh R. , Naik Gurudatta , Natto Zuhair S. , Naveed Muhammad , Nayak Biswa Prakash , Negash Hadush , Nejadghaderi Seyed Aria , Nguyen Dang H. , Nguyen Duc Hoang , Nguyen Hien Quang , Nguyen Phat Tuan , Nguyen Van Thanh , Niazi Robina Khan , Noman Efaq Ali , Oancea Bogdan , Okonji Osaretin Christabel , Olagunju Andrew T. , Olufadewa Isaac Iyinoluwa , Onwujekwe Obinna E. , Opejin Abdulahi Opejin , Ordak Michal , Osuagwu Uchechukwu Levi , Otstavnov Nikita , Owolabi Mayowa O. , Padubidri Jagadish Rao , Panda-Jonas Songhomitra , Pandey Anamika , Pardhan Shahina , Parsaei Amirhossein , Patel Jay , Pawar Shrikant , Perianayagam Arokiasamy , Perumalsamy Navaraj , Pesudovs Konrad , Petcu Ionela-Roxana , Pham Hoang Tran , Pourazizi Mohsen , Prates Elton Junio Sady , Qattea Ibrahim , Raghav Pankaja Raghav , Rahman Mohammad Hifz Ur , Rahman Mosiur , Ramasamy Shakthi Kumaran , Ramasubramani Premkumar , Rashidi Mohammad-Mahdi , Redwan Elrashdy Moustafa Mohamed , Rezaei Nazila , Rodriguez Jefferson Antonio Buendia , Saadatian Zahra , Sabour Siamak , Saddik Basema , Saeed Umar , Safi Sare , Saghazadeh Amene , Sharif-Askari Fatemeh Saheb , Sharif-Askari Narjes Saheb , Sahebkar Amirhossein , Sahraian Mohammad Ali , Sakshaug Joseph W. , Saleh Mohamed A. , Samadzadeh Sara , Samodra Yoseph Leonardo , Samy Abdallah M. , Saylan Mete , Selvaraj Siddharthan , Sethi Yashendra , Seylani Allen , Shahwan Moyad Jamal , Shaikh Masood Ali , Shamim Muhammad Aaqib , Shashamo Bereket Beyene , Shiferaw Wondimeneh Shibabaw , Shigematsu Mika , Shittu Aminu , Shobeiri Parnian , Shorofi Seyed Afshin , Sibhat Migbar Mekonnen , Siddig Emmanuel Edwar , Silva Juan Carlos , Singh Jasvinder A. , Singh Paramdeep , Sotoudeh Houman , Sousa Raúl A. R. C. , Sreeramareddy Chandrashekhar T. , Tabish Mohammad , Taheri Majid , Tan Yao , Taye Birhan Tsegaw , Temsah Mohamad-Hani , Ticoalu Jansje Henny Vera , Tillawi Tala , Tiruneh Misganaw Guadie , Tsatsakis Aristidis , Tsegay Guesh Mebrahtom , Tsilimbaris Miltiadis K. , Ty Sree Sudha , Ubah Chukwudi S. , Umair Muhammad , Tahbaz Sahel Valadan , Valizadeh Rohollah , Viskadourou Maria , Wassie Gizachew Tadesse , Wickramasinghe Nuwan Darshana , Wondimagegn Guadie Sharew , Yahya Galal , Yang Lin , Yao Yao , Yiğit Arzu , Yismaw Yazachew , Yonemoto Naohiro , You Yuyi , Zastrozhin Mikhail Sergeevich , Zenebe Getachew Assefa , Zhang Zhi-Jiang , Zhao Hanqing , Zielińska Magdalena , Zoladl Mohammad , Steinmetz Jaimie D. , Bourne Rupert 
Published: July 2024

Abstract
Background
Uncorrected refractive error (URE) is a readily treatable cause of visual impairment (VI). This study provides updated estimates of global and regional vision loss due to URE, presenting temporal change for VISION 2020

Methods
Data from population-based eye disease surveys from 1980–2018 were collected. Hierarchical models estimated prevalence (95% uncertainty intervals [UI]) of blindness (presenting visual acuity (VA) < 3/60) and moderate-to-severe vision impairment (MSVI; 3/60 ≤ presenting VA < 6/18) caused by URE, stratified by age, sex, region, and year. Near VI prevalence from uncorrected presbyopia was defined as presenting near VA < N6/N8 at 40 cm when best-corrected distance (VA ≥ 6/12).

Results
In 2020, 3.7 million people (95%UI 3.10–4.29) were blind and 157 million (140–176) had MSVI due to URE, 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% (30.7–30.3) and 2.4% (2.6–2.2) respectively during this time. In 2020, South Asia GBD super-region had the highest 50+ years age-standardised URE blindness (0.33% (0.26–0.40%)) and MSVI (10.3% (8.82–12.10%)) rates. 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. An estimated 419 million (295–562) people 50+ had near VI from uncorrected presbyopia, a +75.3% (74.6–76.0) increase from 2000

Conclusions
The number of cases of VI from URE substantively grew, even as age-standardised prevalence fell, since 2000, with a continued disproportionate burden by region and sex. Global population ageing will increase this burden, highlighting urgent need for novel approaches to refractive service delivery.