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Prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe in 2015: magnitude, temporal trends and projections
  1. Rupert R A Bourne1,
  2. Jost B Jonas2,3,
  3. Alain M Bron4,5,6,7,
  4. Maria Vittoria Cicinelli8,
  5. Aditi Das9,
  6. Seth R Flaxman10,11,
  7. David S Friedman12,
  8. Jill E Keeffe13,
  9. John H Kempen14,15,16,
  10. Janet Leasher17,
  11. Hans Limburg18,
  12. Kovin Naidoo19,
  13. Konrad Pesudovs20,
  14. Tunde Peto21,
  15. Jinan Saadine22,
  16. Alexander J Silvester23,
  17. Nina Tahhan24,25,
  18. Hugh R Taylor26,
  19. Rohit Varma27,
  20. Tien Y Wong28,
  21. Serge Resnikoff24,25
  22. on behalf of the Vision Loss Expert Group of the Global Burden of Disease Study
  1. 1 Vision & Eye Research Unit, Anglia Ruskin University, Cambridge, UK
  2. 2 Department of Ophthalmology, Universitätsmedizin, Mannheim, Germany
  3. 3 Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  4. 4 INRA, UMR1324 Centre des Sciences du Goût et de l’Alimentation, Dijon, France
  5. 5 CNRS, UMR6265 Centre des Sciences du Goût et de l’Alimentation, Dijon, France
  6. 6 Centre des Sciences du Goût et de l’Alimentation, Université Bourgogne Franche-Comté, Dijon, France
  7. 7 Ophthalmology Department, Dijon University Hospital, Dijon, France
  8. 8 San Raffaele Scientific Institute, Milan, Italy
  9. 9 Health Education Yorkshire and the Humber, Leeds, UK
  10. 10 Department of Mathematics and Data Science Institute, Imperial College London, London, UK
  11. 11 Department of Statistics, University of Oxford, Oxford, UK
  12. 12 Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  13. 13 LV Prasad Eye Institute, Hyderabad, India
  14. 14 Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
  15. 15 Discovery Eye Center, Addis Ababa, Ethiopia
  16. 16 Myungsung Christian Medical Center and Medical School, Addis Ababa, Ethiopia
  17. 17 Nova Southeastern University, Davie, Florida, USA
  18. 18 Health Information Services, Grootebroek, The Netherlands
  19. 19 African Vision Research Institute, University of Kwazulu-Natal, Brien Holden Vision Institute, Durban, South Africa
  20. 20 NHMRC Centre for Clinical Eye Research, Flinders University, Adelaide, South Australia, Australia
  21. 21 School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
  22. 22 Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  23. 23 St Pauls Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
  24. 24 Brien Holden Vision Institute, Sydney, New South Wales, Australia
  25. 25 School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
  26. 26 Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
  27. 27 Department of Ophthalmology, Keck School of Medicine of USC, Los Angeles, California, USA
  28. 28 Singapore Eye Research Institute, Duke-NUS Graduate Medical School, National University of Singapore, Singapore
  1. Correspondence to Professor Rupert R A Bourne, Vision and Eye Research Unit, School of Medicine, Anglia Ruskin University, Cambridge CB1 1PT, UK; rb{at}


Background Within a surveillance of the prevalence and causes of vision impairment in high-income regions and Central/Eastern Europe, we update figures through 2015 and forecast expected values in 2020.

Methods Based on a systematic review of medical literature, prevalence of blindness, moderate and severe vision impairment (MSVI), mild vision impairment and presbyopia was estimated for 1990, 2010, 2015, and 2020.

Results Age-standardised prevalence of blindness and MSVI for all ages decreased from 1990 to 2015 from 0.26% (0.10–0.46) to 0.15% (0.06–0.26) and from 1.74% (0.76–2.94) to 1.27% (0.55–2.17), respectively. In 2015, the number of individuals affected by blindness, MSVI and mild vision impairment ranged from 70 000, 630 000 and 610 000, respectively, in Australasia to 980 000, 7.46 million and 7.25 million, respectively, in North America and 1.16 million, 9.61 million and 9.47 million, respectively, in Western Europe. In 2015, cataract was the most common cause for blindness, followed by age-related macular degeneration (AMD), glaucoma, uncorrected refractive error, diabetic retinopathy and cornea-related disorders, with declining burden from cataract and AMD over time. Uncorrected refractive error was the leading cause of MSVI.

Conclusions While continuing to advance control of cataract and AMD as the leading causes of blindness remains a high priority, overcoming barriers to uptake of refractive error services would address approximately half of the MSVI burden. New data on burden of presbyopia identify this entity as an important public health problem in this population. Additional research on better treatments, better implementation with existing tools and ongoing surveillance of the problem is needed.

  • public health
  • epidemiology
  • glaucoma

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  • RRAB and JBJ contributed equally.

  • Contributors RRAB, MVC, AD, AJS, NT and TP prepared the vision impairment survey data. SRF and RRAB analysed the data. JBJ and RRAB wrote the first draft of the manuscript. All authors contributed to the study design, analysis and writing of the report. RRAB oversaw the research.

  • Funding This study was funded by the Brien Holden Vision Institute. The results in this paper are prepared independently of the final estimates of the Global Burden of Diseases, Injuries and Risk Factors study.

  • Disclaimer The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

  • Competing interests JBJ: consultant for Mundipharma (Cambridge, UK), patent holder with Biocompatibles UK (Farnham, Surrey, UK) (Title: Treatment of eye diseases using encapsulated cells encoding and secreting neuroprotective factor and/or anti-angiogenic factor; patent no 20120263794) and patent application with University of Heidelberg (Heidelberg, Germany) (Title: Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia; Europäische Patentanmeldung 15 000 771.4). AMB: consultant for Allergan, Bausch + Lomb, Carl Zeiss Meditec, Théa and VISUfarma. Research grants from Horus. JHK: consultant for Gilead and Santen. SR: consultant for Brien Holden Vision Institute.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Global Vision Database (available at:

  • Collaborators A list of the members of the Vision Loss Expert Group of the Global Burden of Disease Study can be found online (

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