Article Text

Ocular and financial health
1. J C Buchan,
2. C Gilbert
1. London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
1. Correspondence to: John Buchan; john.buchan{at}lshtm.ac.uk

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We read with interest the article by Khandekar et al detailing the results of the 1996–7 Omani Eye Study.1 They found a prevalence of blindness of 16.8% in those 60+ years of age, and comment that the population of this age group in Oman is predicted to double by the year 2020. This has serious implications for planning the provision of health care and specifically for eye care services.

This observation is true for most countries; the global population for the over 65 age group is projected to increase from approximately 400 million to 800 million people by the year 2020, contrasting with the under 5 years of age population, which is estimated to see a 6% growth in the same period.2

“Vision 2020—the right to sight” was launched by the WHO and IAPB in 1999, aiming for the elimination of avoidable blindness by the year 2020. In 1995 the estimate of global blindness (<3/60 better eye) was 44 million, and this is projected to rise to 76 million by 2020 if there is no change in current trends.3 Vision 2020 prioritises five diseases for global attention—cataract, refractive errors, trachoma, onchocerciasis, and vitamin A deficiency. Action against diabetic retinopathy and glaucoma is also deemed important in countries where ocular infections have been controlled. Vision 2020 contends that the current increase in blindness, estimated at 1–2 million people per year, can be reversed if human and financial resources are targeted at these priority diseases in the countries with the highest prevalence and number of blind people. It is estimated that the result of a successful programme, achievable at a cost of $2 billion, will be 429 million blind person years avoided over the next 20 years, and a total saving in excess of$100 billion, by avoidance of lost productivity.3 This would make the effective implementation Vision 2020 not only ethically important but also a cost effective strategy for poverty alleviation.

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