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Blindness and visual impairment due to uncorrected refractive error in sub-Saharan Africa: review of recent population-based studies
  1. Justin C Sherwin1,2,
  2. Susan Lewallen3,
  3. Paul Courtright3
  1. 1Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
  2. 2Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia
  3. 3Kilimanjaro Centre for Community Ophthalmology, Moshi, Tanzania
  1. Correspondence to Dr Paul Courtright, Kilimanjaro Centre for Community Ophthalmology, Good Samaritan Foundation, PO Box 2254, Moshi 1, Tanzania; pcourtright{at}


Aim The authors aimed to review published data on uncorrected refractive error (URE) as a cause of blindness and visual impairment in adults aged ≥40 years in sub-Saharan Africa (SSA).

Methods Data were extracted from population-based prevalence surveys measuring presenting visual acuity (PVA). Results from 11 surveys performed in 10 countries in SSA, encompassing 39 458 people aged ≥40 years and older, are presented.

Results The prevalence of blindness (PVA<3/60 in better eye) ranged from 1.1% in an urban district of Cameroon to 7.9% in a rural district in Ethiopia. More than half of studies (6/11) reported no blindness due to URE. The proportion of moderate visual impairment (PVA ≤6/60 and >6/18) due to URE ranged from 12.3% to 57.1%. Excluding two studies that included uncorrected aphakia as part of URE, the highest proportion of blindness and severe visual impairment due to uncorrected aphakia was found in Gambia (15.2%) and Nigeria (15.8%), respectively.

Conclusion Although URE is a leading cause of visual impairment, it does not represent a major cause of blindness in SSA.

  • Uncorrected refractive error
  • epidemiology
  • blindness
  • sub-Saharan Africa
  • Vision 2020
  • public health

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  • Competing interests None.

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

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