Prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe: 1990–2010
- Rupert R A Bourne1,
- Jost B Jonas2,
- Seth R Flaxman3,
- Jill Keeffe4,5,
- Janet Leasher6,
- Kovin Naidoo7,8,
- Maurizio B Parodi9,
- Konrad Pesudovs10,
- Holly Price1,
- Richard A White11,
- Tien Y Wong12,
- Serge Resnikoff8,
- Hugh R Taylor13,
- on behalf of the Vision Loss Expert Group of the Global Burden of Disease Study
- 1Vision & Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, UK
- 2Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- 3School of Computer Science & Heinz College, Carnegie Mellon University, Pittsburgh, USA
- 4Department of Ophthalmology, University of Melbourne, Australia
- 5L V Prasad Eye Institute, Hyderabad, India
- 6Nova Southeastern University, Fort Lauderdale, USA
- 7African Vision Research Institute, University of Kwazulu-Natal, South Africa & Brien Holden Vision Institute, Sydney, Australia
- 8Brien Holden Vision Institute, Sydney, Australia
- 9Department of Ophthalmology, University Vita-Salute, San Raffaele Scientific Hospital, Milan, Italy
- 10NHMRC Centre for Clinical Eye Research, Flinders University, Adelaide, Australia
- 11Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
- 12Singapore Eye Research Institute, Singapore
- 13Melbourne School of Population and Global Health, University of Melbourne, Australia
- Correspondence to Professor Rupert R A Bourne, Vision and Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK;
Background To assess prevalence and causes of blindness and vision impairment in high-income regions and in Central/Eastern Europe in 1990 and 2010.
Methods Based on a systematic review of medical literature, prevalence of moderate and severe vision impairment (MSVI; presenting visual acuity <6/18 but ≥3/60 in the better eye) and blindness (presenting visual acuity <3/60) was estimated for 1990 and 2010.
Results Age-standardised prevalence of blindness and MSVI decreased from 0.2% to 0.1% (3.314 million to 2.736 million people) and from 1.6% to 1.0% (25.362 million to 22.176 million), respectively. Women were generally more affected than men. Cataract was the most frequent cause of blindness in all subregions in 1990, but macular degeneration and uncorrected refractive error became the most frequent causes of blindness in 2010 in all high-income countries, except for Eastern/Central Europe, where cataract remained the leading cause. Glaucoma and diabetic retinopathy were fourth and fifth most common causes for blindness for all regions at both times. Uncorrected refractive error, followed by cataract, macular degeneration, glaucoma and diabetic retinopathy, was the most common cause for MSVI in 1990 and 2010.
Conclusions In highly developed countries, prevalence of blindness and MSVI has been reduced by 50% and 38%, respectively, and the number of blind people and people with MSVI decreased by 17.4% and 12.6%, respectively, even with the increasing number of older people in the population. In high-income countries, macular degeneration has become the most important cause of blindness, but uncorrected refractive errors continue to be the leading cause of MSVI.