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Global issues
Prevalence and causes of vision loss in South-east Asia and Oceania in 2015: magnitude, temporal trends and projections
  1. Jill Elizabeth Keeffe1,
  2. Robert J Casson2,
  3. Konrad Pesudovs,
  4. Hugh R Taylor3,
  5. Maria Vittoria Cicinelli4,
  6. Aditi Das5,
  7. Seth R Flaxman6,
  8. Jost B Jonas7,
  9. John H Kempen8,9,10,
  10. Janet Leasher11,
  11. Hans Limburg12,
  12. Kovin Naidoo13,
  13. Alexander J Silvester14,
  14. Gretchen A Stevens15,
  15. Nina Tahhan16,17,
  16. Tien Yin Wong18,
  17. Serge Resnikoff16,17,
  18. Rupert R A Bourne19
  19. on behalf of the Vision Loss Expert Group of the Global Burden of Disease Study
  1. 1 L V Prasad Eye Institute, Hyderabad, India
  2. 2 University of Adelaide, Adelaide, South Australia, Australia
  3. 3 Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
  4. 4 San Raffaele Scientific Institute, Milan, Italy
  5. 5 Health Education Yorkshire, London, UK
  6. 6 Department of Mathematics and Data Science Institute, Imperial College London, London, UK
  7. 7 Department of Ophthalmology, Universitätsmedizin, Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  8. 8 Immunology and Uveitis Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
  9. 9 Discovery Eye Center, Leawood, Kansas, USA
  10. 10 MyungSung Christian Medical Center, Addis Ababa, Ethiopia
  11. 11 Nova Southeastern University, Fort Lauderdale, Florida, USA
  12. 12 Health Information Services, Grootebroek, The Netherlands
  13. 13 African Vision Research Institute, University of Kwazulu-Natal, South Africa & Brien Holden Vision Institute, Sydney, New South Wales, Australia
  14. 14 St Pauls Eye Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool, UK
  15. 15 Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
  16. 16 Brien Holden Vision Institute, Sydney, New South Wales, Australia
  17. 17 School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
  18. 18 Singapore Eye Research Institute, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore
  19. 19 Vision & Eye Research Unit, Anglia Ruskin University, Cambridge, UK
  1. Correspondence to Professor Jill Elizabeth Keeffe, L V Prasad Eye Institute, Hyderabad, Telangana 500034, India; jillkeeffe{at}lvpei.org

Abstract

Background To assess prevalence and causes of vision impairment in South-east Asia and Oceania regions from 1990 to 2015 and to forecast the figures for 2020.

Methods Based on a systematic review of medical literature, prevalence of blindness (presenting visual acuity (PVA) <3/60 in the better eye), moderate and severe vision impairment (MSVI; PVA <6/18 but ≥3/60), mild vision impairment (PVA <6/12 but ≥6/18) and near vision impairment (>N5 or N8 in the presence of normal vision) were estimated for 1990, 2010, 2015 and 2020.

Results The age-standardised prevalence of blindness for all ages and both genders was higher in the Oceania region but lower for MSVI when comparing the subregions. The prevalence of near vision impairment in people≥50 years was 41% (uncertainty interval (UI) 18.8 to 65.9). Comparison of the data for 2015 with 2020 predicts a small increase in the numbers of people affected by blindness, MSVI and mild VI in both subregions. The numbers predicted for near VI in South-east Asia are from 90.68 million in 2015 to 102.88 million in 2020. The main causes of blindness and MSVI in both subregions in 2015 were cataract, uncorrected refractive error, glaucoma, corneal disease and age-related macular degeneration. There was no trachoma in Oceania from 1990 and decreasing prevalence in South-east Asia with elimination predicted by 2020.

Conclusions In both regions, the main challenges for eye care come from cataract which remains the main cause of blindness with uncorrected refractive error the main cause of MSVI. The trend between 1990 and 2015 is for a lower prevalence of blindness and MSVI in both regions.

  • global burden of disease study
  • vision loss expert group
  • blindness
  • vision impairment
  • epidemiology

https://doi.org/10.1136/bjophthalmol-2018-311946

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    Footnotes

    • Collaborators Group Information: A list of the members of the Vision Loss Expert Group of the Global Burden of Disease Study can be found by accessing this site: http://www.anglia.ac.uk/epidemiology/

    • Contributors SR, RRAB, AJS, AD, MVC, JEK, RJC, KP and HRT prepared the vision impairment survey data. SR, GAS and RRAB analysed the data. JEK, RJC, KP and HRT the first draft of the report.

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

    • Disclaimer The author is a staff member of the WHO. The author alone is responsible for the views expressed in this publication and they do not necessarily represent the decisions, policy or views of the World Health Organization.

    • Competing interests JBJ: Consultant for Mundipharma Co. (Cambridge, UK); Patent holder with Biocompatibles UK Ltd. (Farnham, Surrey, UK) (Title: Treatment of eye diseases using encapsulated cells encoding and secreting neuroprotective factor and/or ant-angiogenic factor; Patent number: 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.

    • Patient consent Not required.

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

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