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

Rupert R.A. Bourne; Jaimie D. Steinmetz; Mete Saylan; Abera M. Mersha; Abrha Hailay Weldemariam; Temesgen Gebeyehu Wondmeneh; Chandrashekhar T. Sreeramareddy; Marina Pinheiro; Mehdi Yaseri; Chuanhua Yu; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Zhi Jiang Zhang; Stephanie R.M. Zimsen; Naohiro Yonemoto; Gebiyaw Wudie Tsegaye; Giang Thu Vu; Avina Vongpradith; Andre M.N. Renzaho; Muluken Bekele Sorrie; Amira A. Shaheen; Wondimeneh Shibabaw Shiferaw; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Ganesh Kumar Saya; Vafa Rahimi-Movaghar; Mika Shigematsu; Mohammad Ali Sahraian; Homa Naderifar; Siamak Sabour; Priya Rathi; Brijesh Sathian; Ted R. Miller; Aziz Rezapour; Lal Rawal; Hai Quang Pham; Utsav Parekh; Vivek Podder; Obinna E. Onwujekwe; Maja Pasovic; Nikita Otstavnov; Hadush Negash; Shrikant Pawar; Mukhammad David Naimzada; Ahmed Al Montasir; Felix Akpojene Ogbo; Nathan G. Congdon; David S. Friedman; Tunde Peto; Gianni Virgili; GBD 2019 Blindness and Vision Impairment Collaborators; Vision Loss Expert Group of the Global Burden of Disease Study

doi:10.1016/S2214-109X(20)30489-7

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

Rupert R.A. Bourne^*, Jaimie D. Steinmetz, Mete Saylan, Abera M. Mersha, Abrha Hailay Weldemariam, Temesgen Gebeyehu Wondmeneh, Chandrashekhar T. Sreeramareddy, Marina Pinheiro, Mehdi Yaseri, Chuanhua Yu, Mikhail Sergeevich Zastrozhin, Anasthasia Zastrozhina, Zhi Jiang Zhang, Stephanie R.M. Zimsen, Naohiro Yonemoto, Gebiyaw Wudie Tsegaye, Giang Thu Vu, Avina Vongpradith, Andre M.N. Renzaho, Muluken Bekele SorrieAmira A. Shaheen, Wondimeneh Shibabaw Shiferaw, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Ganesh Kumar Saya, Vafa Rahimi-Movaghar, Mika Shigematsu, Mohammad Ali Sahraian, Homa Naderifar, Siamak Sabour, Priya Rathi, Brijesh Sathian, Ted R. Miller, Aziz Rezapour, Lal Rawal, Hai Quang Pham, Utsav Parekh, Vivek Podder, Obinna E. Onwujekwe, Maja Pasovic, Nikita Otstavnov, Hadush Negash, Shrikant Pawar, Mukhammad David Naimzada, Ahmed Al Montasir, Felix Akpojene Ogbo, Nathan G. Congdon, David S. Friedman, Tunde Peto, Gianni Virgili, GBD 2019 Blindness and Vision Impairment Collaborators, Vision Loss Expert Group of the Global Burden of Disease Study

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

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.

Methods
We 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.

Original language	English
Pages (from-to)	e144-e160
Journal	The Lancet Global Health
Volume	9
Issue number	2
Early online date	01 Dec 2020
DOIs	https://doi.org/10.1016/S2214-109X(20)30489-7
Publication status	Published - Feb 2021

ASJC Scopus subject areas

General Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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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
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Bourne, R. R. A., Steinmetz, J. D., Saylan, M., Mersha, A. M., Weldemariam, A. H., Wondmeneh, T. G., Sreeramareddy, C. T., Pinheiro, M., Yaseri, M., Yu, C., Zastrozhin, M. S., Zastrozhina, A., Zhang, Z. J., Zimsen, S. R. M., Yonemoto, N., Tsegaye, G. W., Vu, G. T., Vongpradith, A., Renzaho, A. M. N., ... Vision Loss Expert Group of the Global Burden of Disease Study (2021). 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. The Lancet Global Health, 9(2), e144-e160. https://doi.org/10.1016/S2214-109X(20)30489-7

@article{33eb46875d684ebda3b4d5cb527110d7,

title = "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",

abstract = "BackgroundMany 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.FindingsGlobal 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]).InterpretationResults 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.",

author = "Bourne, {Rupert R.A.} and Steinmetz, {Jaimie D.} and Mete Saylan and Mersha, {Abera M.} and Weldemariam, {Abrha Hailay} and Wondmeneh, {Temesgen Gebeyehu} and Sreeramareddy, {Chandrashekhar T.} and Marina Pinheiro and Mehdi Yaseri and Chuanhua Yu and Zastrozhin, {Mikhail Sergeevich} and Anasthasia Zastrozhina and Zhang, {Zhi Jiang} and Zimsen, {Stephanie R.M.} and Naohiro Yonemoto and Tsegaye, {Gebiyaw Wudie} and Vu, {Giang Thu} and Avina Vongpradith and Renzaho, {Andre M.N.} and Sorrie, {Muluken Bekele} and Shaheen, {Amira A.} and Shiferaw, {Wondimeneh Shibabaw} and Skryabin, {Valentin Yurievich} and Skryabina, {Anna Aleksandrovna} and Saya, {Ganesh Kumar} and Vafa Rahimi-Movaghar and Mika Shigematsu and Sahraian, {Mohammad Ali} and Homa Naderifar and Siamak Sabour and Priya Rathi and Brijesh Sathian and Miller, {Ted R.} and Aziz Rezapour and Lal Rawal and Pham, {Hai Quang} and Utsav Parekh and Vivek Podder and Onwujekwe, {Obinna E.} and Maja Pasovic and Nikita Otstavnov and Hadush Negash and Shrikant Pawar and Naimzada, {Mukhammad David} and {Al Montasir}, Ahmed and Ogbo, {Felix Akpojene} and Congdon, {Nathan G.} and Friedman, {David S.} and Tunde Peto and Gianni Virgili and {GBD 2019 Blindness and Vision Impairment Collaborators} and {Vision Loss Expert Group of the Global Burden of Disease Study}",

year = "2021",

month = feb,

doi = "10.1016/S2214-109X(20)30489-7",

language = "English",

volume = "9",

pages = "e144--e160",

journal = "The Lancet Global Health",

issn = "2214-109X",

publisher = "Elsevier B.V.",

number = "2",

}

Bourne, RRA, Steinmetz, JD, Saylan, M, Mersha, AM, Weldemariam, AH, Wondmeneh, TG, Sreeramareddy, CT, Pinheiro, M, Yaseri, M, Yu, C, Zastrozhin, MS, Zastrozhina, A, Zhang, ZJ, Zimsen, SRM, Yonemoto, N, Tsegaye, GW, Vu, GT, Vongpradith, A, Renzaho, AMN, Sorrie, MB, Shaheen, AA, Shiferaw, WS, Skryabin, VY, Skryabina, AA, Saya, GK, Rahimi-Movaghar, V, Shigematsu, M, Sahraian, MA, Naderifar, H, Sabour, S, Rathi, P, Sathian, B, Miller, TR, Rezapour, A, Rawal, L, Pham, HQ, Parekh, U, Podder, V, Onwujekwe, OE, Pasovic, M, Otstavnov, N, Negash, H, Pawar, S, Naimzada, MD, Al Montasir, A, Ogbo, FA, Congdon, NG, Friedman, DS, Peto, T, Virgili, G, GBD 2019 Blindness and Vision Impairment Collaborators & Vision Loss Expert Group of the Global Burden of Disease Study 2021, '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', The Lancet Global Health, vol. 9, no. 2, pp. e144-e160. https://doi.org/10.1016/S2214-109X(20)30489-7

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. / Bourne, Rupert R.A.; Steinmetz, Jaimie D.; Saylan, Mete et al.
In: The Lancet Global Health, Vol. 9, No. 2, 02.2021, p. e144-e160.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - 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

AU - Bourne, Rupert R.A.

AU - Steinmetz, Jaimie D.

AU - Saylan, Mete

AU - Mersha, Abera M.

AU - Weldemariam, Abrha Hailay

AU - Wondmeneh, Temesgen Gebeyehu

AU - Sreeramareddy, Chandrashekhar T.

AU - Pinheiro, Marina

AU - Yaseri, Mehdi

AU - Yu, Chuanhua

AU - Zastrozhin, Mikhail Sergeevich

AU - Zastrozhina, Anasthasia

AU - Zhang, Zhi Jiang

AU - Zimsen, Stephanie R.M.

AU - Yonemoto, Naohiro

AU - Tsegaye, Gebiyaw Wudie

AU - Vu, Giang Thu

AU - Vongpradith, Avina

AU - Renzaho, Andre M.N.

AU - Sorrie, Muluken Bekele

AU - Shaheen, Amira A.

AU - Shiferaw, Wondimeneh Shibabaw

AU - Skryabin, Valentin Yurievich

AU - Skryabina, Anna Aleksandrovna

AU - Saya, Ganesh Kumar

AU - Rahimi-Movaghar, Vafa

AU - Shigematsu, Mika

AU - Sahraian, Mohammad Ali

AU - Naderifar, Homa

AU - Sabour, Siamak

AU - Rathi, Priya

AU - Sathian, Brijesh

AU - Miller, Ted R.

AU - Rezapour, Aziz

AU - Rawal, Lal

AU - Pham, Hai Quang

AU - Parekh, Utsav

AU - Podder, Vivek

AU - Onwujekwe, Obinna E.

AU - Pasovic, Maja

AU - Otstavnov, Nikita

AU - Negash, Hadush

AU - Pawar, Shrikant

AU - Naimzada, Mukhammad David

AU - Al Montasir, Ahmed

AU - Ogbo, Felix Akpojene

AU - Congdon, Nathan G.

AU - Friedman, David S.

AU - Peto, Tunde

AU - Virgili, Gianni

AU - GBD 2019 Blindness and Vision Impairment Collaborators

AU - Vision Loss Expert Group of the Global Burden of Disease Study

PY - 2021/2

Y1 - 2021/2

N2 - BackgroundMany 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.FindingsGlobal 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]).InterpretationResults 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.

AB - BackgroundMany 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.FindingsGlobal 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]).InterpretationResults 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.

U2 - 10.1016/S2214-109X(20)30489-7

DO - 10.1016/S2214-109X(20)30489-7

M3 - Article

C2 - 33275949

AN - SCOPUS:85099179366

SN - 2214-109X

VL - 9

SP - e144-e160

JO - The Lancet Global Health

JF - The Lancet Global Health

IS - 2

ER -

Bourne RRA, Steinmetz JD, Saylan M, Mersha AM, Weldemariam AH, Wondmeneh TG et al. 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. The Lancet Global Health. 2021 Feb;9(2):e144-e160. Epub 2020 Dec 1. doi: 10.1016/S2214-109X(20)30489-7