Causes of vision loss worldwide, 1990-2010: a systematic analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of global observational prevalence data
PubMed 25104599 · doi:10.1016/S2214-109X(13)70113-X
What was done
Systematic analysis of published and unpublished survey data (1980–2012) to estimate the global and regional proportions of blindness (visual acuity <3/60 in the better eye) and moderate and severe vision impairment (MSVI; visual acuity <6/18 to ≥3/60) attributable to cataract, glaucoma, macular degeneration, diabetic retinopathy, trachoma, and uncorrected refractive error in 1990 and 2010 by age, sex, and geography.
What was found
In 2010, 65% (95% uncertainty interval [UI] 61–68) of 32.4 million blind individuals and 76% (95% UI 73–79) of 191 million individuals with MSVI had preventable or treatable causes, compared to 68% (95% UI 65–70) of 31.8 million and 80% (95% UI 78–83) of 172 million in 1990. Leading global causes of blindness in 1990 vs 2010 were cataract (39% vs 33%), uncorrected refractive error (20% vs 21%), and macular degeneration (5% vs 7%). Leading causes of MSVI in 1990 vs 2010 were uncorrected refractive error (51% vs 53%), cataract (26% vs 18%), and macular degeneration (2% vs 3%). In all regions, more women than men had blindness or MSVI from cataract and macular degeneration.
Why it matters
These global burden estimates show that although the relative contribution of cataract has decreased, the overwhelming majority of global vision loss remains avoidable through standard interventions for refractive error and cataracts.
Limits
The abstract does not report the total number of studies included, search parameters, or specific statistical modeling methods used to impute missing data across regions. Findings rely on heterogeneous observational surveys with variable diagnostic criteria and potential measurement error.
Cited by
- contradicts Macular degeneration is the largest cause of blindness besides glaucoma.