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

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. We did a systematic analysis of published and unpublished data on the causes of blindness (visual acuity in the better e...

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Published in:	The Lancet global health Vol. 1; no. 6; pp. e339 - e349
Main Authors:	Bourne, Rupert R A, Stevens, Gretchen A, White, Richard A, Smith, Jennifer L, Flaxman, Seth R, Price, Holly, Jonas, Jost B, Keeffe, Jill, Leasher, Janet, Naidoo, Kovin, Pesudovs, Konrad, Resnikoff, Serge, Taylor, Hugh R
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01.12.2013 Elsevier
Subjects:	Blindness - etiology Cataract - complications Diabetic Retinopathy - complications Female Glaucoma - complications Global Health Humans Internal Medicine Macular Degeneration - complications Male Trachoma - complications Vision Disorders - etiology
ISSN:	2214-109X, 2214-109X
Online Access:	Get full text
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Abstract	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. We did a systematic analysis of published and unpublished data on the causes of blindness (visual acuity in the better eye less than 3/60) and moderate and severe vision impairment ([MSVI] visual acuity in the better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. 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. The differences and temporal changes we found in causes of blindness and MSVI have implications for planning and resource allocation in eye care. Bill & Melinda Gates Foundation, Fight for Sight, Fred Hollows Foundation, and Brien Holden Vision Institute.
AbstractList	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. 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. 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. 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. The differences and temporal changes we found in causes of blindness and MSVI have implications for planning and resource allocation in eye care. Bill & Melinda Gates Foundation, Fight for Sight, Fred Hollows Foundation, and Brien Holden Vision Institute. Summary 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. 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.BACKGROUNDData 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.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.METHODSWe 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.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.FINDINGSIn 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.The differences and temporal changes we found in causes of blindness and MSVI have implications for planning and resource allocation in eye care.INTERPRETATIONThe differences and temporal changes we found in causes of blindness and MSVI have implications for planning and resource allocation in eye care.Bill & Melinda Gates Foundation, Fight for Sight, Fred Hollows Foundation, and Brien Holden Vision Institute.FUNDINGBill & Melinda Gates Foundation, Fight for Sight, Fred Hollows Foundation, and Brien Holden Vision Institute.
Author	Smith, Jennifer L Keeffe, Jill Bourne, Rupert R A Resnikoff, Serge Jonas, Jost B White, Richard A Pesudovs, Konrad Flaxman, Seth R Price, Holly Leasher, Janet Stevens, Gretchen A Naidoo, Kovin Taylor, Hugh R
Author_xml	– sequence: 1 givenname: Rupert R A surname: Bourne fullname: Bourne, Rupert R A email: rb@rupertbourne.co.uk organization: Vision and Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, UK – sequence: 2 givenname: Gretchen A surname: Stevens fullname: Stevens, Gretchen A organization: Department of Health Statistics and Information Systems, WHO, Geneva, Switzerland – sequence: 3 givenname: Richard A surname: White fullname: White, Richard A organization: Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway – sequence: 4 givenname: Jennifer L surname: Smith fullname: Smith, Jennifer L organization: Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK – sequence: 5 givenname: Seth R surname: Flaxman fullname: Flaxman, Seth R organization: School of Computer Science and Heinz College, Carnegie Mellon University, Pittsburgh, PA, USA – sequence: 6 givenname: Holly surname: Price fullname: Price, Holly organization: Vision and Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, UK – sequence: 7 givenname: Jost B surname: Jonas fullname: Jonas, Jost B organization: Department of Ophthalmology, Universitätsmedizin, Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany – sequence: 8 givenname: Jill surname: Keeffe fullname: Keeffe, Jill organization: LV Prasad Eye Institute, Hyderabad, India – sequence: 9 givenname: Janet surname: Leasher fullname: Leasher, Janet organization: College of Optometry, Nova Southeastern University, Fort-Lauderdale-Davie, FL, USA – sequence: 10 givenname: Kovin surname: Naidoo fullname: Naidoo, Kovin organization: African Vision Research Institute, University of Kwazulu-Natal, South Africa – sequence: 11 givenname: Konrad surname: Pesudovs fullname: Pesudovs, Konrad organization: NHMRC Centre for Clinical Eye Research, Flinders University, Adelaide, SA, Australia – sequence: 12 givenname: Serge surname: Resnikoff fullname: Resnikoff, Serge organization: International Health and Development, Geneva, Switzerland – sequence: 13 givenname: Hugh R surname: Taylor fullname: Taylor, Hugh R organization: Melbourne School of Public Health, University of Melbourne, Melbourne, VIC, Australia
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/25104599$$D View this record in MEDLINE/PubMed
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ContentType	Journal Article
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Copyright	2013 Bourne et al. Open Access article distributed under the terms of CC BY Bourne et al. Open Access article distributed under the terms of CC BY Copyright © 2013 Bourne et al. Open Access article distributed under the terms of CC BY. Published by .. All rights reserved.
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Snippet	Data on causes of vision impairment and blindness are important for development of public health policies, but comprehensive analysis of change in prevalence... Summary Background Data on causes of vision impairment and blindness are important for development of public health policies, but comprehensive analysis of... Background: Data on causes of vision impairment and blindness are important for development of public health policies, but comprehensive analysis of change in...
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SubjectTerms	Blindness - etiology Cataract - complications Diabetic Retinopathy - complications Female Glaucoma - complications Global Health Humans Internal Medicine Macular Degeneration - complications Male Trachoma - complications Vision Disorders - etiology
Title	Causes of vision loss worldwide, 1990–2010: a systematic analysis
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