Effective refractive error coverage in adults aged 50 years and older: estimates from population-based surveys in 61 countries

Rupert Richard Alexander Bourne; Maria Vittoria Cicinelli; Tabassom Sedighi; Ian H Tapply; Ian McCormick; Jost B Jonas; Nathan G Congdon; Jacqueline Ramke; Kovin S Naidoo; Timothy R Fricke; Matthew J Burton; Andreas Müller; Mukharram M Bikbov; João M Furtado; Fatima Kyari; Mingguang He; Ya Xing Wang; Lingam Vijaya; Vinay Nangia; Garry Brian; Mohammad Hassan Emamian; Akbar Fotouhi; Hassan Hashemi; Rajiv B Khandekar; Srinivas Marmamula; Solange Salomão; Ronnie George; Gyulli Kazakbaeva; Tasanee Braithwaite; Robert J Casson; Aiko Iwase; Noopur Gupta; Mohammad H Abdianwall; Rohit Varma; Tien Y Wong; Ningli Wang; Hugh R Taylor; Seth R Flaxman; Stuart Keel; Serge Resnikoff; Vision Loss Expert Group of the Global Burden of Disease Study; RAAB International Co-Author Group

doi:10.1016/S2214-109X(22)00433-8

Effective refractive error coverage in adults aged 50 years and older: estimates from population-based surveys in 61 countries

Lancet Glob Health. 2022 Dec;10(12):e1754-e1763. doi: 10.1016/S2214-109X(22)00433-8. Epub 2022 Oct 11.

Authors

Rupert Richard Alexander Bourne¹, Maria Vittoria Cicinelli², Tabassom Sedighi³, Ian H Tapply⁴, Ian McCormick⁵, Jost B Jonas⁶, Nathan G Congdon⁷, Jacqueline Ramke⁵, Kovin S Naidoo⁸, Timothy R Fricke⁹, Matthew J Burton⁵, Andreas Müller¹⁰, Mukharram M Bikbov¹¹, João M Furtado¹², Fatima Kyari⁵, Mingguang He¹³, Ya Xing Wang¹⁴, Lingam Vijaya¹⁵, Vinay Nangia¹⁶, Garry Brian¹⁷, Mohammad Hassan Emamian¹⁸, Akbar Fotouhi¹⁹, Hassan Hashemi²⁰, Rajiv B Khandekar²¹, Srinivas Marmamula²², Solange Salomão²³, Ronnie George¹⁵, Gyulli Kazakbaeva¹¹, Tasanee Braithwaite²⁴, Robert J Casson²⁵, Aiko Iwase²⁶, Noopur Gupta²⁷, Mohammad H Abdianwall²⁸, Rohit Varma²⁹, Tien Y Wong³⁰, Ningli Wang¹⁴, Hugh R Taylor³¹, Seth R Flaxman³², Stuart Keel¹⁰, Serge Resnikoff⁹; Vision Loss Expert Group of the Global Burden of Disease Study; RAAB International Co-Author Group

Collaborators

Alain Bron, Ching-Yu Cheng, Arthur Fernandes, David Friedman, Andrew Gazzard, Rim Kahloun, John Kempen, Moncef Khairallah, Van C Lansingh, Janet Leasher, Nicolas Leveziel, Hans Limburg, Michal Nowak, Konrad Pesudovs, Tunde Peto, Luca Rossetti, Nina Tahhan, Rohit Varma, Wondu Alemayehu, Aries Arditi, Reza Dana, Monte Del Monte, Jenny Deva, Laura Dreer, Josh Ehrlich, Leon Ellwein, Billy Hammond, Mary E Hartnett, April Ingram, Rohit Khanna, Judy Kim, Jennifer Lim, Alan Morse, David Musch, Maurizio B Parodi, Pradeep Ramulu, Alan Robin, Janet Serle, Tueng Shen, Rita S Sitorus, Dwight Stambolian, Fotis Topouzis, Miltiadis Tsilimbaris, Gianni Virgili, Sheila West, Jafer K Ababora, Heba AlSawahli, Hery Harimanitra Andriamanjato, Rosario Barrenechea, Juan F Batlle, Anthea M Burnett, Robert P Finger, Marcelo Gallarreta, Pedro A Gomez-Bastar, Reeta Gurung, Elesh Jain, George E Kabona, Khumbo Kalua, Levi Kandeke, Jefitha Karimurio, Susan A Kikira, Sucheta Kulkarni, Van C Lansingh, Wanjiku Mathenge, Sailesh Kumar Mishra, Seyed Farzad Mohammadi, Manfred Mörchen, Nasiru Muhammad, Grace C Mutati, Maria Eugenia Nano, János Németh, Ala Paduca, Alexander Páez, M Mansur Rabiu, Lutfah Rif'ati, Mohamad Aziz Salowi, Yuddha D Sapkota, Nicholas Sargent, Ubeydulla Thoufeeq, Astrid V Villalobos, Biaxiang Xiao, Mariano Yee Melgar, Xiu Juan Zhang

Affiliations

¹ Anglia Ruskin University, Cambridge, UK. Electronic address: [email protected].
² Department of Ophthalmology, San Raffaele Hospital, Milan, Italy.
³ Anglia Ruskin University, Cambridge, UK.
⁴ Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
⁵ London School of Hygiene & Tropical Medicine, London, UK.
⁶ Heidelberg University, Mannheim, Germany.
⁷ Queen's University, Belfast, UK.
⁸ University of KwaZulu-Natal, Durban, South Africa.
⁹ University of New South Wales School of Optometry and Vision Science, Sydney, NSW, Australia.
¹⁰ WHO, Geneva, Switzerland.
¹¹ Ufa Eye Research Institute, Ufa, Russia.
¹² University of Sao Paulo, Sao Paulo, Brazil.
¹³ The University of Melbourne, Melbourne, VIC, Australia.
¹⁴ Beijing Institute of Ophthalmology, Beijing, China.
¹⁵ Medical Research Foundation, Chennai, India.
¹⁶ Suraj Eye Institute, Nagpur, India.
¹⁷ The Fred Hollows Foundation, New Zealand.
¹⁸ Shahroud University of Medical Sciences, Shahroud, Iran.
¹⁹ Tehran University of Medical Sciences, Tehran, Iran.
²⁰ NOOR Ophthalmology Research Center, Tehran, Iran.
²¹ King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
²² LV Prasad Eye Institute, Hyderabad, India.
²³ Department of Ophthalmology and Visual Science, Paulista School of Medicina, Federal University of São Paulo, São Paulo, Brazil.
²⁴ St Thomas' Hospital, London, UK.
²⁵ The University of Adelaide School of Public Health, Adelaide, Australia.
²⁶ Japan Glaucoma Society, Japan.
²⁷ All India Institute of Medical Sciences, New Delhi, India.
²⁸ Bayazid Roshan University of Nangarhar Faculty of Medicine, Jalalabad, Afghanistan.
²⁹ Southern California Eye Institute, Los Angeles, CA, USA.
³⁰ Tsinghua University School of Medicine, Beijing, China.
³¹ School of Population and Global Health, Melbourne, VIC, Australia.
³² University of Oxford Department of Computing Science, Oxford, UK.

PMID: 36240807
DOI: 10.1016/S2214-109X(22)00433-8

Abstract

Background: In 2021, WHO Member States endorsed a global target of a 40-percentage-point increase in effective refractive error coverage (eREC; with a 6/12 visual acuity threshold) by 2030. This study models global and regional estimates of eREC as a baseline for the WHO initiative.

Methods: The Vision Loss Expert Group analysed data from 565 448 participants of 169 population-based eye surveys conducted since 2000 to calculate eREC (met need/[met need + undermet need + unmet need]). A binary logistic regression model was used to estimate eREC by Global Burden of Disease (GBD) Study super region among adults aged 50 years and older.

Findings: In 2021, distance eREC was 79·1% (95% CI 72·4-85·0) in the high-income super region; 62·1% (54·7-68·8) in north Africa and Middle East; 49·5% (45·0-54·0) in central Europe, eastern Europe, and central Asia; 40·0% (31·7-48·2) in southeast Asia, east Asia, and Oceania; 34·5% (29·4-40·0) in Latin America and the Caribbean; 9·0% (6·5-12·0) in south Asia; and 5·7% (3·1-9·0) in sub-Saharan Africa. eREC was higher in men and reduced with increasing age. Global distance eREC increased from 2000 to 2021 by 19·0%. Global near vision eREC for 2021 was 20·5% (95% CI 17·8-24·4).

Interpretation: Over the past 20 years, distance eREC has increased in each super region yet the WHO target will require substantial improvements in quantity and quality of refractive services in particular for near vision impairment.

Funding: WHO, Sightsavers, The Fred Hollows Foundation, Fondation Thea, Brien Holden Vision Institute, Lions Clubs International Foundation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Africa South of the Sahara
Aged
Europe
Global Burden of Disease
Global Health*
Humans
Male
Middle Aged
Refractive Errors* / epidemiology
Refractive Errors* / therapy

Grants and funding

001/WHO_/World Health Organization/International