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Lancet Glob Health. 2013 Dec;1(6):e339-49. doi: 10.1016/S2214-109X(13)70113-X. Epub 2013 Nov 11.

Causes of vision loss worldwide, 1990-2010: a systematic analysis.

Author information

  • 1Vision and Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, UK. Electronic address: rb@rupertbourne.co.uk.
  • 2Department of Health Statistics and Information Systems, WHO, Geneva, Switzerland.
  • 3Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
  • 4Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
  • 5School of Computer Science and Heinz College, Carnegie Mellon University, Pittsburgh, PA, USA.
  • 6Vision and Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, UK.
  • 7Department of Ophthalmology, Universitätsmedizin, Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
  • 8LV Prasad Eye Institute, Hyderabad, India.
  • 9College of Optometry, Nova Southeastern University, Fort-Lauderdale-Davie, FL, USA.
  • 10African Vision Research Institute, University of Kwazulu-Natal, South Africa; Brien Holden Vision Institute, Sydney, NSW, Australia.
  • 11NHMRC Centre for Clinical Eye Research, Flinders University, Adelaide, SA, Australia.
  • 12International Health and Development, Geneva, Switzerland.
  • 13Melbourne School of Public Health, University of Melbourne, Melbourne, VIC, Australia.

Abstract

BACKGROUND:

Data on causes of vision impairment and blindness are important for development of public health policies, but comprehensive analysis of change in prevalence over time is lacking.

METHODS:

We did a systematic analysis of published and unpublished data on the causes of blindness (visual acuity in the better eye less than 3/60) and moderate and severe vision impairment ([MSVI] visual acuity in the better eye less than 6/18 but at least 3/60) from 1980 to 2012. We estimated the proportions of overall vision impairment attributable to cataract, glaucoma, macular degeneration, diabetic retinopathy, trachoma, and uncorrected refractive error in 1990-2010 by age, geographical region, and year.

FINDINGS:

In 2010, 65% (95% uncertainty interval [UI] 61-68) of 32·4 million blind people and 76% (73-79) of 191 million people with MSVI worldwide had a preventable or treatable cause, compared with 68% (95% UI 65-70) of 31·8 million and 80% (78-83) of 172 million in 1990. Leading causes worldwide in 1990 and 2010 for blindness were cataract (39% and 33%, respectively), uncorrected refractive error (20% and 21%), and macular degeneration (5% and 7%), and for MSVI were uncorrected refractive error (51% and 53%), cataract (26% and 18%), and macular degeneration (2% and 3%). Causes of blindness varied substantially by region. Worldwide and in all regions more women than men were blind or had MSVI due to cataract and macular degeneration.

INTERPRETATION:

The differences and temporal changes we found in causes of blindness and MSVI have implications for planning and resource allocation in eye care.

FUNDING:

Bill & Melinda Gates Foundation, Fight for Sight, Fred Hollows Foundation, and Brien Holden Vision Institute.

Copyright © 2013 Bourne et al. Open Access article distributed under the terms of CC BY. Published by .. All rights reserved.

PMID:
25104599
[PubMed - in process]
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