Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study
Authors: Jaimie D Steinmetz, Rupert R A Bourne, Paul Svitil Briant, Seth R Flaxman, Hugh R B Taylor, Jost B Jonas, Amir Aberhe Abdoli, Woldu Aberhe Abrha, Ahmed Abualhasan, Eman Girum Abu-Gharbieh, Tadele Girum Adal, Ashkan Afshin, Hamid Ahmadieh, Wondu Alemayehu, Sayyed Amirpooya Samir Alemzadeh, Ahmed Samir Alfaar, Vahid Alipour, Sofia Androudi, Jalal Arabloo, Aries Berhe Arditi, Brhane Berhe Aregawi, Alessandro Arrigo, Charlie Ashbaugh, Elham Debalkie Ashrafi, Desta Debalkie Atnafu, Eleni Amin Bagli, Atif Amin Winfried Baig, Till Winfried Bärnighausen, Maurizio Battaglia Parodi, Mahya Srikanth Beheshti, Akshaya Srikanth Bhagavathula, Nikha Bhardwaj, Pankaj Bhardwaj, Krittika Bhattacharyya, Ali Bijani, Mukharram Bikbov, Michele Bottone, Tasanee M Braithwaite, Alain M Bron, Sharath A Burugina Nagaraja, Zahid A Butt, Florentino Luciano L Caetano dos Santos, Vera L James Carneiro, Robert James Casson, Ching-Yu Jasmine Cheng, Jee-Young Jasmine Choi, Dinh-Toi Chu, Maria Vittoria M Cicinelli, João M G Coelho, Nathan G A Congdon, Rosa A A Couto, Elizabeth A M Cromwell, Saad M Dahlawi, Xiaochen Dai, Reza Dana, Lalit Dandona, Rakhi A Dandona, Monte A Del Monte, Meseret Derbew Molla, Nikolaos Alemayehu Dervenis, Abebaw Alemayehu P Desta, Jenny P Deva, Daniel Diaz, Shirin E Djalalinia, Joshua R Ehrlich, Rajesh Rashad Elayedath, Hala Rashad B Elhabashy, Leon B Ellwein, Mohammad Hassan Emamian, Sharareh Eskandarieh, Farshad G Farzadfar, Arthur G Fernandes, Florian S Fischer, David S M Friedman, João M Furtado, Shilpa Gaidhane, Gus Gazzard, Berhe Gebremichael, Ronnie George, Ahmad Ghashghaee, Syed Amir Gilani, Mahaveer Golechha, Samer Randall Hamidi, Billy Randall R Hammond, Mary Elizabeth R Kusuma Hartnett, Risky Kusuma Hartono, Abdiwahab I Hashi, Simon I Hay, Khezar Hayat, Golnaz Heidari, Hung Chak Ho, Ramesh Holla, Mowafa J Househ, John J Emmanuel Huang, Segun Emmanuel M Ibitoye, Irena M D Ilic, Milena D D Ilic, April D Naghibi Ingram, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Ramaiah Itumalla, Shubha Prakash Jayaram, Ravi Prakash Jha, Rim Kahloun, Rohollah Kalhor, Himal Kandel, Ayele Semachew Kasa, Taras A Kavetskyy, Gbenga A H Kayode, John H Kempen, Moncef Khairallah, Rovshan Ahmad Khalilov, Ejaz Ahmad C Khan, Rohit C Khanna, Mahalaqua Nazli Ahmed Khatib, Tawfik Ahmed E Khoja, Judy E Kim, Yun Jin Kim, Gyu Ri Kim, Sezer Kisa, Adnan Kisa, Soewarta Kosen, Ai Koyanagi, Burcu Kucuk Bicer, Vaman P Kulkarni, Om P Kurmi, Iván Charles Landires, Van Charles L Lansingh, Janet L E Leasher, Kate E LeGrand, Nicolas Leveziel, Hans Limburg, Xuefeng Liu, Shilpashree Madhava Kunjathur, Shokofeh Maleki, Navid Manafi, Kaweh Mansouri, Colm Gebremichael McAlinden, Gebrekiros Gebremichael M Meles, Abera M Mersha, Irmina Maria R Michalek, Ted R Miller, Sanjeev Misra, Yousef Mohammad, Seyed Farzad Abdu Mohammadi, Jemal Abdu H Mohammed, Ali H Mokdad, Mohammad Ali Al Moni, Ahmed Al R Montasir, Alan R Fentaw Morse, Getahun Fentaw C Mulaw, Mehdi Naderi, Homa S Naderifar, Kovin S Naidoo, Mukhammad David Naimzada, Vinay Nangia, Sreenivas Muhammad Narasimha Swamy, Dr Muhammad Naveed, Hadush Lan Negash, Huong Lan Nguyen, Virginia Akpojene Nunez-Samudio, Felix Akpojene Ogbo, Kolawole T Ogundimu, Andrew T E Olagunju, Obinna E Onwujekwe, Nikita O Otstavnov, Mayowa O Owolabi, Keyvan Pakshir, Songhomitra Panda-Jonas, Utsav Parekh, Eun-Cheol Park, Maja Pasovic, Shrikant Pawar, Konrad Pesudovs, Tunde Quang Peto, Hai Quang Pham, Marina Pinheiro, Vivek Podder, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Y Rahman, Pradeep Y Ramulu, Priya Rathi, Salman Laith Rawaf, David Laith Rawaf, Lal Rawal, Nickolas M Reinig, Andre M Renzaho, Aziz L Rezapour, Alan L Robin, Luca Rossetti, Siamak Sabour, Sare Safi, Amirhossein Sahebkar, Mohammad Ali M Sahraian, Abdallah M Samy, Brijesh Sathian, Ganesh Kumar Saya, Mete A Saylan, Amira A Ali Shaheen, Masood Ali T Shaikh, Tueng T Shen, Kenji Shibabaw Shibuya, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Jae Il Shin, Juan Carlos Silva, Alexander A Silvester, Jasvinder A Singh, Deepika S Singhal, Rita S Sitorus, Eirini Yurievich Skiadaresi, Valentin Yurievich Aleksandrovna Skryabin, Anna Aleksandrovna Skryabina, Amin Bekele Soheili, Muluken Bekele A R C Sorrie, Raúl A R C T Sousa, Chandrashekhar T Sreeramareddy, Dwight Girma Stambolian, Eyayou Girma Tadesse, Nina Ismail Tahhan, Md Ismail Tareque, Fotis Xuan Topouzis, Bach Xuan Tran, Gebiyaw K Tsegaye, Miltiadis K Tsilimbaris, Rohit Varma, Gianni Virgili, Avina Thu Vongpradith, Giang Thu Vu, Ya Xing Wang, Ningli Hailay Wang, Abrha Hailay K Weldemariam, Sheila K Gebeyehu West, Temesgen Gebeyehu Y Wondmeneh, Tien Y Wong, Mehdi Yaseri, Naohiro Yonemoto, Chuanhua Sergeevich Yu, Mikhail Sergeevich Zastrozhin, Zhi-Jiang R Zhang, Stephanie R Zimsen, Serge Resnikoff, Theo Vos
Journal: The Lancet Global Health (2020)

Background Many causes of vision impairment can be prevented or treated.With an ageing global population, the demands for eye health services are increasing.We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020.We aimed to compare the results with the World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in avoidable vision impairment, defined as cataract and undercorrected refractive error. MethodsWe did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018.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 or less than 10° visual field around central fixation) by cause, age, region, and year.Because of data sparsity at younger ages, our analysis focused on adults aged 50 years and older.Findings Global crude prevalence of avoidable vision impairment and blindness in adults aged 50 years and older did not change between 2010 and 2019 (percentage change -0•2% [95% UI -1•5 to 1•0]; 2019 prevalence 9•58 cases per 1000 people [95% IU 8•51 to 10•8], 2010 prevalence 96•0 cases per 1000 people [86•0 to 107•0]).Age-standardised prevalence of avoidable blindness decreased by -15•4% [-16•8 to -14•3], while avoidable MSVI showed no change (0•5% [-0•8 to 1•6]).However, the number of cases increased for both avoidable blindness (10•8% [8•9 to 12•4]) and MSVI (31•5% [30•0 to 33•1]).The leading global causes of blindness in those aged 50 years and older in 2020 were cataract (15•2 million cases [9% IU 12•7-18•0]), followed by glaucoma (3•6 million cases [2•8-4•4]), undercorrected refractive error (2•3 million cases [1•8-2•8]), age-related macular degeneration (1•8 million cases [1•3-2•4]), and diabetic retinopathy (0•86 million cases [0•59-1•23]).Leading causes of MSVI were undercorrected refractive error (86•1 million cases [74•2-101•0]) and cataract (78•8 million cases [67•2-91•4]).Interpretation Results suggest eye care services contributed to the observed reduction of age-standardised rates of avoidable blindness but not of MSVI, and that the target in an ageing global population was not reached.