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

GBD 2019 Blindness and Vision Impairment Collaborators, 246 authors, including; Rupert R A Bourne; Hung Chak Ho; on behalf of the 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

GBD 2019 Blindness and Vision Impairment Collaborators, 246 authors, including
, Rupert R A Bourne^*
, Hung Chak Ho
, on behalf of the Vision Loss Expert Group of the Global Burden of Disease Study

^*Corresponding author for this work

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

2743 Citations (Scopus)

38 Downloads (CityUHK Scholars)

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
Online published	1 Dec 2020
DOIs	https://doi.org/10.1016/S2214-109X(20)30489-7
Publication status	Published - Feb 2021
Externally published	Yes

Funding

This manuscript was produced as part of the GBD Collaborator Network and in accordance with the GBD protocol. T W Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. R R A Bourne received institutional support from Anglia Ruskin University, Cambridge, UK. G Gazzard is employed by University College London (London, UK) and supported by grants from the NIHR (HTA 09/104/40), Moorfields Eye Charity, British Council to Prevent Blindness, and Fight for Sight and the International Glaucoma Association. M E R Hartnett's work is supported by grants from NIH R01 EY015130, NIH R01 EY017011, and NIH EY014800 Unrestricted Grant from Research to Prevent Blindness (NY, USA) to the Department of Ophthalmology & Visual Sciences, University of Utah (Salt Lake City, UT, USA). S M S Islam received funding from National Health and Medical Research Council (NHMRC) and National Heart Foundation. J H Kempen received support from the Massachusetts Eye and Ear Global Surgery Program; Sight for Souls. Y J Kim received support by the Research Management Centre, Xiamen University Malaysia [XMUMRF/2020-C6/ITCM/0004]. I Landires is a member of the Sistema Nacional de Investigación (SNI), which is supported by the Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT), Panamá. A M Samy received support from a fellowship from the Egyptian Fulbright Mission Program. D Stambolia received research support from the National Eye Institute of the NIH under Award Number R01EY031209.

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GBD 2019 Blindness and Vision Impairment Collaborators, 246 authors, including, Bourne, R. R. A., Ho, H. C., & on behalf of the 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

GBD 2019 Blindness and Vision Impairment Collaborators, 246 authors, including ; Bourne, Rupert R A ; Ho, Hung Chak 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. In: The Lancet Global Health. 2021 ; Vol. 9, No. 2. pp. e144-e160.

@article{a42cd10fad0c4ec0a15f1b060aa7a94c,

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 = "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. {\textcopyright} 2020 The Author(s). Published by Elsevier Ltd.",

author = "\{GBD 2019 Blindness and Vision Impairment Collaborators, 246 authors, including\} and 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 Owolabi, \{Mayowa O.\} and Xuefeng Liu and Cheng, \{Ching Yu\} and Ho, \{Hung Chak\} and \{on behalf of the 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",

}

GBD 2019 Blindness and Vision Impairment Collaborators, 246 authors, including, Bourne, RRA, Ho, HC & on behalf of the 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. / GBD 2019 Blindness and Vision Impairment Collaborators, 246 authors, including; Bourne, Rupert R A; Ho, Hung Chak et al.
In: The Lancet Global Health, Vol. 9, No. 2, 02.2021, p. e144-e160.

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › 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

T2 - The Right to Sight: An analysis for the Global Burden of Disease Study

AU - GBD 2019 Blindness and Vision Impairment Collaborators, 246 authors, including

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 - Owolabi, Mayowa O.

AU - Liu, Xuefeng

AU - Cheng, Ching Yu

AU - Ho, Hung Chak

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

PY - 2021/2

Y1 - 2021/2

N2 - 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. © 2020 The Author(s). Published by Elsevier Ltd.

AB - 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. © 2020 The Author(s). Published by Elsevier Ltd.

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GBD 2019 Blindness and Vision Impairment Collaborators, 246 authors, including, Bourne RRA, Ho HC, on behalf of the Vision Loss Expert Group of the Global Burden of Disease Study. 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

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

Funding

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