The Lancet Global Health (Dec 2017)
Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis
- Seth R Flaxman, PhD,
- Rupert R A Bourne, ProfMD,
- Serge Resnikoff, ProfMD,
- Peter Ackland, MPhil,
- Tasanee Braithwaite, MPH,
- Maria V Cicinelli, MD,
- Aditi Das, MD,
- Jost B Jonas, ProfMD,
- Jill Keeffe, ProfPhD,
- John H Kempen, MD,
- Janet Leasher, ProfOD,
- Hans Limburg, PhD,
- Kovin Naidoo, PhD,
- Konrad Pesudovs, ProfPhD,
- Alex Silvester, MD,
- Gretchen A Stevens, D.Sc,
- Nina Tahhan, PhD,
- Tien Y Wong, ProfPhD,
- Hugh R Taylor, MD,
- Rupert Bourne,
- Peter Ackland,
- Aries Arditi,
- Yaniv Barkana,
- Banu Bozkurt,
- Tasanee Braithwaite,
- Alain Bron,
- Donald Budenz,
- Feng Cai,
- Robert Casson,
- Usha Chakravarthy,
- Jaewan Choi,
- Maria Vittoria Cicinelli,
- Nathan Congdon,
- Reza Dana,
- Rakhi Dandona,
- Lalit Dandona,
- Aditi Das,
- Iva Dekaris,
- Monte Del Monte,
- Jenny deva,
- Laura Dreer,
- Leon Ellwein,
- Marcela Frazier,
- Kevin Frick,
- David Friedman,
- Joao Furtado,
- Hua Gao,
- Gus Gazzard,
- Ronnie George,
- Stephen Gichuhi,
- Victor Gonzalez,
- Billy Hammond,
- Mary Elizabeth Hartnett,
- Minguang He,
- James Hejtmancik,
- Flavio Hirai,
- John Huang,
- April Ingram,
- Jonathan Javitt,
- Jost Jonas,
- Charlotte Joslin,
- Jill Keeffe,
- John Kempen,
- Moncef Khairallah,
- Rohit Khanna,
- Judy Kim,
- George Lambrou,
- Van Charles Lansingh,
- Paolo Lanzetta,
- Janet Leasher,
- Jennifer Lim,
- Hans LIMBURG,
- Kaweh Mansouri,
- Anu Mathew,
- Alan Morse,
- Beatriz Munoz,
- David Musch,
- Kovin Naidoo,
- Vinay Nangia,
- Maria Palaiou,
- Maurizio Battaglia Parodi,
- Fernando Yaacov Pena,
- Konrad Pesudovs,
- Tunde Peto,
- Harry Quigley,
- Murugesan Raju,
- Pradeep Ramulu,
- Zane Rankin,
- Serge Resnikoff,
- Dana Reza,
- Alan Robin,
- Luca Rossetti,
- Jinan Saaddine,
- Mya Sandar,
- Janet Serle,
- Tueng Shen,
- Rajesh Shetty,
- Pamela Sieving,
- Juan Carlos Silva,
- Alex Silvester,
- Rita S. Sitorus,
- Dwight Stambolian,
- Gretchen Stevens,
- Hugh Taylor,
- Jaime Tejedor,
- James Tielsch,
- Miltiadis Tsilimbaris,
- Jan van Meurs,
- Rohit Varma,
- Gianni Virgili,
- Ya Xing Wang,
- Ning-Li Wang,
- Sheila West,
- Peter Wiedemann,
- Tien Wong,
- Richard Wormald,
- Yingfeng Zheng
Affiliations
- Seth R Flaxman, PhD
- Department of Mathematics and Data Science Institute, Imperial College London, London, UK
- Rupert R A Bourne, ProfMD
- Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK; Correspondence to: Prof Rupert R A Bourne, Vision and Eye Research Unit, Anglia Ruskin University, Cambridge CB1 1PT, UK
- Serge Resnikoff, ProfMD
- Brien Holden Vision Institute, Sydney, NSW, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
- Peter Ackland, MPhil
- International Agency for the Prevention of Blindness, London, UK
- Tasanee Braithwaite, MPH
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Maria V Cicinelli, MD
- San Raffaele Scientific Institute, Milan, Italy
- Aditi Das, MD
- York Hospital, York, UK
- Jost B Jonas, ProfMD
- Department of Ophthalmology, Universitätsmedizin, Mannheim, Germany; Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Jill Keeffe, ProfPhD
- L V Prasad Eye Institute, Hyderabad, India
- John H Kempen, MD
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA; Discovery Eye Center, Addis Ababa, Ethiopia; MyungSung Christian Medical Center, Addis Ababa, Ethiopia
- Janet Leasher, ProfOD
- Nova Southeastern University, Fort Lauderdale, FL, USA
- Hans Limburg, PhD
- Health Information Services, Grootebroek, Netherlands
- Kovin Naidoo, PhD
- Brien Holden Vision Institute, Sydney, NSW, Australia; African Vision Research Institute, University of Kwazulu-Natal, Glenwood, Durban, South Africa
- Konrad Pesudovs, ProfPhD
- National Health and Medical Research Council Centre for Clinical Eye Research, Flinders University, Adelaide, SA, Australia
- Alex Silvester, MD
- SpaMedica Research Institute, Bolton, UK
- Gretchen A Stevens, D.Sc
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
- Nina Tahhan, PhD
- Brien Holden Vision Institute, Sydney, NSW, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
- Tien Y Wong, ProfPhD
- Singapore Eye Research Institute, Duke-National University of Singapore Graduate Medical School, National University of Singapore, Singapore
- Hugh R Taylor, MD
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Rupert Bourne
- Peter Ackland
- Aries Arditi
- Yaniv Barkana
- Banu Bozkurt
- Tasanee Braithwaite
- Alain Bron
- Donald Budenz
- Feng Cai
- Robert Casson
- Usha Chakravarthy
- Jaewan Choi
- Maria Vittoria Cicinelli
- Nathan Congdon
- Reza Dana
- Rakhi Dandona
- Lalit Dandona
- Aditi Das
- Iva Dekaris
- Monte Del Monte
- Jenny deva
- Laura Dreer
- Leon Ellwein
- Marcela Frazier
- Kevin Frick
- David Friedman
- Joao Furtado
- Hua Gao
- Gus Gazzard
- Ronnie George
- Stephen Gichuhi
- Victor Gonzalez
- Billy Hammond
- Mary Elizabeth Hartnett
- Minguang He
- James Hejtmancik
- Flavio Hirai
- John Huang
- April Ingram
- Jonathan Javitt
- Jost Jonas
- Charlotte Joslin
- Jill Keeffe
- John Kempen
- Moncef Khairallah
- Rohit Khanna
- Judy Kim
- George Lambrou
- Van Charles Lansingh
- Paolo Lanzetta
- Janet Leasher
- Jennifer Lim
- Hans LIMBURG
- Kaweh Mansouri
- Anu Mathew
- Alan Morse
- Beatriz Munoz
- David Musch
- Kovin Naidoo
- Vinay Nangia
- Maria Palaiou
- Maurizio Battaglia Parodi
- Fernando Yaacov Pena
- Konrad Pesudovs
- Tunde Peto
- Harry Quigley
- Murugesan Raju
- Pradeep Ramulu
- Zane Rankin
- Serge Resnikoff
- Dana Reza
- Alan Robin
- Luca Rossetti
- Jinan Saaddine
- Mya Sandar
- Janet Serle
- Tueng Shen
- Rajesh Shetty
- Pamela Sieving
- Juan Carlos Silva
- Alex Silvester
- Rita S. Sitorus
- Dwight Stambolian
- Gretchen Stevens
- Hugh Taylor
- Jaime Tejedor
- James Tielsch
- Miltiadis Tsilimbaris
- Jan van Meurs
- Rohit Varma
- Gianni Virgili
- Ya Xing Wang
- Ning-Li Wang
- Sheila West
- Peter Wiedemann
- Tien Wong
- Richard Wormald
- Yingfeng Zheng
- Journal volume & issue
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Vol. 5,
no. 12
pp. e1221 – e1234
Abstract
Summary: Background: Contemporary data for causes of vision impairment and blindness form an important basis of recommendations in public health policies. Refreshment of the Global Vision Database with recently published data sources permitted modelling of cause of vision loss data from 1990 to 2015, further disaggregation by cause, and forecasts to 2020. Methods: In this systematic review and meta-analysis, we analysed published and unpublished population-based data for the causes of vision impairment and blindness from 1980 to 2014. We identified population-based studies published before July 8, 2014, by searching online databases with no language restrictions (MEDLINE from Jan 1, 1946, and Embase from Jan 1, 1974, and the WHO Library Database). We fitted a series of regression models to estimate the proportion of moderate or severe vision impairment (defined as presenting visual acuity of 14% of blindness) as causes in the high-income subregions. Blindness and vision impairment at all ages in 2015 due to diabetic retinopathy (odds ratio 2·52 [1·48–3·73]) and cataract (1·21 [1·17–1·25]) were more common among women than among men, whereas blindness and vision impairment due to glaucoma (0·71 [0·57–0·86]) and corneal opacity (0·54 [0·43–0·66]) were more common among men than among women, with no sex difference related to age-related macular degeneration (0·91 [0·70–1·14]). Interpretation: The number of people affected by the common causes of vision loss has increased substantially as the population increases and ages. Preventable vision loss due to cataract (reversible with surgery) and refractive error (reversible with spectacle correction) continue to cause most cases of blindness and moderate or severe vision impairment in adults aged 50 years and older. A large scale-up of eye care provision to cope with the increasing numbers is needed to address avoidable vision loss. Funding: Brien Holden Vision Institute.
