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Prevalence and causes of vision loss in Latin America and the Caribbean in 2015: magnitude, temporal trends and projections
  1. Janet L Leasher1,
  2. Tasanee Braithwaite2,
  3. João M Furtado3,
  4. Seth R Flaxman4,
  5. Van Charles Lansingh5,6,
  6. Juan Carlos Silva7,
  7. Serge Resnikoff8,
  8. Hugh R Taylor9,
  9. Rupert R A Bourne10
  10. on behalf of the Vision Loss Expert Group of the Global Burden of Disease Study
    1. 1 College of Optometry, Nova Southeastern University, Fort Lauderdale, Florida, USA
    2. 2 Moorfields Eye Hospital, London, UK
    3. 3 Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
    4. 4 Department of Mathematics and Data Science Institute, Imperial College London, London, UK
    5. 5 HelpMeSee, Inc., New York City, New York, USA
    6. 6 Instituto Mexicano de Oftalmología, Querétaro, Mexico
    7. 7 Pan American Health Organization, Bogotá, Colombia
    8. 8 Brien Holden Vision Institute & School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
    9. 9 Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
    10. 10 Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
    1. Correspondence to Professor Rupert R A Bourne, Vision and Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Cambridge CB1 1PT, UK; rb{at}rupertbourne.co.uk

    Abstract

    Objective To estimate the prevalence and causes of blindness and vision impairment for distance and near in Latin America and the Caribbean (LAC) in 2015 and to forecast trends to 2020.

    Methods A meta-analysis from a global systematic review of 283 cross-sectional, population-representative studies from published and unpublished sources from 1980 to 2014 in the Global Vision Database included 17 published and 6 unpublished studies from LAC.

    Results In 2015, across LAC, age-standardised prevalence was 0.38% in all ages and 1.56% in those over age 50 for blindness; 2.06% in all ages and 7.86% in those over age 50 for moderate and severe vision impairment (MSVI); 1.89% in all ages and 6.93% in those over age 50 for mild vision impairment and 39.59% in all ages and 45.27% in those over 50 for near vision impairment (NVI). In 2015, 117.86 million persons were vision impaired; of those 2.34 million blind, 12.46 million with MSVI, 11.34 million mildly impaired and 91.72 million had NVI. Cataract is the most common cause of blindness. Undercorrected refractive-error is the most common cause of vision impairment.

    Conclusions These prevalence estimates indicate that one in five persons across LAC had some degree of vision loss in 2015. We predict that from 2015 to 2020, the absolute numbers of persons with vision loss will increase by 12% to 132.33 million, while the all-age age-standardised prevalence will decrease for blindness by 15% and for other distance vision impairment by 8%. All countries need epidemiologic research to establish accurate national estimates and trends. Universal eye health services must be included in universal health coverage reforms to address disparities, fragmentation and segmentation of healthcare

    • epidemiology
    • public health
    • vision

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    Footnotes

    • SR, HRT and RRAB are joint senior authors.

    • Collaborators GBD Vision Loss Expert Group Members: Rupert Bourne (Anglia Ruskin University, Cambridge, UK); Peter Ackland (International Agency for Prevention of Blindness, London, UK); Aries Arditi (Visibility Metrics LLC, New York, USA); yaniv barkana (Assaf Harofe Medical Center, Zerifin, Israel); Banu Bozkurt (Department of Ophthalmology, Meram Medical Faculty, Selcuk University, Konya, Turkey); Tasanee Braithwaite (Moorfields Eye Hospital, London); Alain Bron (Service d’Ophtalmologie CHU Dijon, France); Donald Budenz (University of Miami, Miami, USA); Feng Cai (Green-Valley Group, Freedom, California, USA); Robert Casson (University of Adelaide, Adelaide, Australia); Usha Chakravarthy (The Queen’s University of Belfast, Belfast, Northern Ireland); Jaewan Choi (Hangil Eye Hospital, Incheon, South Korea); Maria Vittoria Cicinelli (San Raffaele Scientific Institute, Milan, Italy); Nathan Congdon (The Queen’s University of Belfast, Belfast, Northern Ireland); Reza Dana (Massachussets Eye & Ear Infirmary, Harvard Medical School, Boston, USA); Rakhi Dandona (George Institute for International Health, Sydney, Australia); Lalit Dandona (Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA); Aditi Das (St James’s University Hospital, Leeds, UK); Iva Dekaris (Eye Clinic Svjetlost, Zagreb, Croatia); Monte Del Monte, MD (University of Michigan, Ann Arbor, USA); Jenny Deva (Universiti Tunku Abdul Rahman, Dept of Surgery (Ophthalmology)); Mohamed Dirani (Singapore Eye Research Institute, Singapore); Laura Dreer (University of Alabama, Birmingham, USA); Leon Ellwein (National Eye Institute, Bethesda, USA); Marcela Frazier (University of Alabama at Birmingham); Kevin Frick (Johns Hopkins Bloomberg School of Public Health, Baltimore, USA); David Friedman (Johns Hopkins Bloomberg School of Public Health, Baltimore, USA); Joao Furtado (University of São Paulo, São Paulo , Brazil); Hua Gao (Henry Ford Medical Center, Dept of Ophthalmology); Andrew Gazzard (Institute of Ophthalmology, London); Ronnie George (Medical Research Foundation, Chennai, India); Stephen Gichuhi (University of Nairobi, Nairobi, Kenya); Victor Gonzalez (Valley Retina Institute, Texas, USA); Billy Hammond (University of Georgia, Athens, USA); Mary Elizabeth Hartnett (University of Utah, Salt Lake City, USA); Minguang He (University of Melbourne, Melbourne, USA); James Hejtmancik (National Eye Institute, Bethesda, USA); Flavio Hirai (Federal University of Sao Paulo, Brazil); John Huang (Yale University School of Medicine, Connecticut, USA); April Ingram (Alberta Children’s Hospital, Calgary, Canada); Jonathan Javitt (Johns Hopkins University School of Medicine, Baltimore, USA); Jost Jonas (Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany); Charlotte Joslin (University of Illinois, Chicago, USA); Jill Keeffe (L V Prasad Eye Institute, Hyderabad, India); John Kempen (University of Pennsylvania Perelman School of Medicine, Philadelphia, USA); Moncef Khairallah (University Hospital Monastir,Tunisia); Rohit Khanna (L V Prasad Eye Institute, Hyderabad, India); Judy Kim (Medical College of Wisconsin, Milwaukee, USA); George Lambrou (Novartis, Basel, Switzerland); Van Charles Lansingh (HelpMeSee, Inc. New York, USA); Paolo Lanzetta (Department of Ophthalmology, University of Udine. Udine, Italy); Janet Leasher (Nova Southeastern University, Florida, USA); Jennifer Lim (University of Illinois, Urbana, USA); Hans Limburg (Health Information Services, Grootebroek, Netherlands); Kaweh Mansouri (Clinique De Montchoisi, Lausanne, Switzerland); Anu Mathew (Royal Children’s Hospital, Melbourne, Australia); Alan Morse (Jewish Guild Healthcare, New York, USA); Beatriz Munoz (Wilmer Eye Institute John Hopkins University, Baltimore, USA); David Musch (University of Michigan, Ann Arbor, USA); Kovin Naidoo (University of KwaZulu-Natal, Durban, South Africa); Vinay Nangia (Suraj Eye Institute, Nagpur, India); Maria Palaiou (Massachusetts Eye and Ear Institute, Boston, USA); Maurizio Battaglia Parodi (University Vita Salute, Ospedale San Raffaele, Milan, Italy); Fernando Yaacov Pena (Fundacion Vision, Asuncion, Paraguay); Konrad Pesudovs (Adelaide, Australia); Tunde Peto (The Queen’s University of Belfast, Belfast, Northern Ireland); Harry Quigley (Wilmer Eye Institute John Hopkins University, Baltimore, USA); Murugesan Raju (University of Missouri, Columbia, USA); Pradeep Ramulu (Wilmer Eye Institute John Hopkins University, Baltimore, USA); Serge Resnikoff (Brien Holden Vision Institute, Sydney, Australia); Dana Reza (Schepens Eye Research Inst./Mass Eye and Ear, Harvard Medical School, Boston, USA); Alan Robin (Johns Hopkins University, Baltimore, USA); Luca Rossetti (University of Milan, Milan, Italy); Jinan Saaddine (National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, USA); Mya Sandar (Singapore Eye Research Institute, Singapore); Janet Serle (Mt Sinai School of Medicine, New York, USA); Tueng Shen (University of Washington, Seattle, USA); Rajesh Shetty (Mayo Clinic, Minnesota, USA); Pamela Sieving (National Institutes of Health, Bethesda, USA); Juan Carlos Silva (Pan-American Health Organization, Columbia); Alex Silvester (St Paul’s Eye Unit, Royal Liverpool University Hospital.Liverpool, UK); Rita S Sitorus (Department of Ophthalmology, Faculty of Medicine University of Indonesia, Depok, Indonesia); Dwight Stambolian (University of Pennsylvania, Philadelphia, USA); Gretchen Stevens (World Health Organization, Geneva, Switzerland); Hugh Taylor (Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia); JaimeTejedor (Hospital Raman y Cajal, Madrid, Spain); James Tielsch (Johns Hopkins Bloomberg School of Public Health, Baltimore, USA); Fotis Topouzis (University of Thessaloniki, Greece); Miltiadis Tsilimbaris (University of Crete Medical School, Crete); Janvan Meurs (The Rotterdam Eye Hospital and Erasmus University, Rotterdam, Netherlands); Rohit Varma (Department of Ophthalmology for Keck School of Medicine, University of Southern California, USA); Gianni Virgili (Department of Ophthalmology, University of Florence, Italy); Jimmy Volmink (Faculty of Health Sciences, Stellenbosch University, South Africa); Ya Xing Wang (Capital Medical University, Beijing, China); Ning-Li Wang (Eye Centre of Beijing Tongren Hospital, Beijing, China); Sheila West (Johns Hopkins Hospital, Baltimore, USA); Peter Wiedemann (Leipzig University, Leipzig, Germany); Tien Wong (University of Melbourne, Melbourne, Australia); Richard Wormald (Moorfields Eye Hospital, London); Yingfeng Zheng (Singapore Eye Research Institute, Singapore).

    • Contributors Substantial contributions to conception and design, acquisition of data or analysis and interpretation of data: JLL, TB, SRF, JMF, VCL, JCS, SR, HRT, RRAB. Statistical analysis: SRF. Drafting the article or revising it critically for important intellectual content: JLL, TB, JMF, VCL, JCS, SR, HRT, RRAB. Final approval of the version to be published: JLL, VCL, JMF, TB, JCS, SRF, SR, HRT, RRAB.

    • Funding This study was partially funded by the Brien Holden Vision Institute.

    • Disclaimer The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. While the work reported here was performed by the Vision Loss Expert Group as part of the Global Burden of Disease, Risk Factors and Injuries Study 2015, the results prepared here by the authors in this paper were prepared independently of the final estimates of the Global Burden of Disease 2015.

    • Competing interests None declared.

    • Patient consent Not required.

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

    • Data sharing statement Unpublished data enquiries may be directed to: Rupert Bourne BSc FRCOphth MD rb@rupertbourne.co.uk

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