Data show progress in reducing global preventable blindness, but disparities remain
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SAN FRANCISCO — Data provided by the Vision Loss Expert Group, an international, ophthalmic epidemiology reference group, shows an encouraging trend towards increased coverage of refractive error and cataract surgery globally.
However, disparities between high and low-income nations as well as between genders still exist, Rupert Bourne, BSc, FRCOphth, MD, said at the American Academy of Ophthalmology meeting.
The Vision Loss Expert Group works closely with the WHO and other international eye care organizations to collect and provide actionable data for global eye health projects.
“From 2010, the Vision Loss Expert Group has done systematic regular review. We have an electronic database called the Global Vision database, and every 5 years, we've been able to provide updates on the numbers of people with vision loss and blindness and look at change over time,” Bourne said.
Estimates from 2020 showed that, globally, 43 million people were blind, 257 million had mild vision impairment, 295 million had moderate to severe vision impairment and 507 million people were estimated to be near-vision impaired, with increasing prevalence due to ageing of the population.
However, change in age-standardized prevalence of blindness over a 30-year period showed a negative trend for all causes except diabetic retinopathy.
“We are making good progress in terms of reducing the age-standardized prevalence of blindness,” Bourne said. “But the pressures of aging and changes in population growth are actually pulling us in the opposite direction.”
At 2021’s World Health Assembly, WHO set two global eyecare targets for 2030 — a 40% increase in effective refractive error coverage (eREC) and 30% increase in effective cataract surgery coverage (eCSC).
These indicators “are linked to two of the most cost-effective interventions in the health care sector,” Bourne said.
“They are linked to diseases with very high prevalence, which is expected to increase, and consider different segments of the population. As you all know, there is a huge unmet need for treatments,” he explained.
Data collected by the Vision Loss Expert Group for WHO showed that, globally, 17% of people are currently effectively covered by cataract surgery, and 35% wear appropriate spectacles. However, there is wide variation between high- and low-income countries, with eCSC ranging from 4.1% to 48.7% and eREC ranging from 3.5% to 89.9% in different regions.
“There are important sex differences as well. Effective cataract surgery coverage is greater in men by 3.5% and effective refractive error coverage has a male preponderance of 10.4% higher,” Bourne said. “As you would expect, the coverage for refractive error and for cataract surgery reduces as you go from high-income countries down to low-income countries,” Bourne said.
Editor's note: The first paragraph of this article was updated on Dec. 21, 2023, to more accurately reflect the name of the Vision Loss Expert Group. The editors regret the error.
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Bourne R. Global priorities for 2030: Subspecialty service needs and trends. Presented at: American Academy of Ophthalmology meeting; Nov. 3-6, 2023; San Francisco.
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