Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study
Open accessAbstract
BACKGROUND: To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990-2020, and forecasts for 2050. METHODS: We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. Only studies with samples representative of the population and with clearly defined visual acuity testing protocols were included. We fitted hierarchical models to estimate 2020 prevalence (with 95% uncertainty intervals [UIs]) of mild vision impairment (presenting visual acuity ≥6/18 and <6/12), moderate and severe vision impairment (<6/18 to 3/60), and blindness (<3/60 or less than 10° visual field around central fixation); and vision impairment from uncorrected presbyopia (presenting near vision <N6 or <N8 at 40 cm where best-corrected distance visual acuity is ≥6/12). We forecast estimates of vision loss up to 2050. FINDINGS: In 2020, an estimated 43·3 million (95% UI 37·6-48·4) people were blind, of whom 23·9 million (55%; 20·8-26·8) were estimated to be female. We estimated 295 million (267-325) people to have moderate and severe vision impairment, of whom 163 million (55%; 147-179) were female; 258 million (233-285) to have mild vision impairment, of whom 142 million (55%; 128-157) were female; and 510 million (371-667) to have visual impairment from uncorrected presbyopia, of whom 280 million (55%; 205-365) were female. Globally, between 1990 and 2020, among adults aged 50 years or older, age-standardised prevalence of blindness decreased by 28·5% (-29·4 to -27·7) and prevalence of mild vision impairment decreased slightly (-0·3%, -0·8 to -0·2), whereas prevalence of moderate and severe vision impairment increased slightly (2·5%, 1·9 to 3·2; insufficient data were available to calculate this statistic for vision impairment from uncorrected presbyopia). In this period, the number of people who were blind increased by 50·6% (47·8 to 53·4) and the number with moderate and severe vision impairment increased by 91·7% (87·6 to 95·8). By 2050, we predict 61·0 million (52·9 to 69·3) people will be blind, 474 million (428 to 518) will have moderate and severe vision impairment, 360 million (322 to 400) will have mild vision impairment, and 866 million (629 to 1150) will have uncorrected presbyopia. INTERPRETATION: Age-adjusted prevalence of blindness has reduced over the past three decades, yet due to population growth, progress is not keeping pace with needs. We face enormous challenges in avoiding vision impairment as the global population grows and ages. FUNDING: Brien Holden Vision Institute, Fondation Thea, Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.
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- Authors
- Bourne, R., Steinmetz, J. D., Flaxman, S., Briant, P. S., Taylor, H. R., Resnikoff, S., Casson, R. J., Abdoli, A., Abu-Gharbieh, E., Afshin, A., Ahmadieh, H., Akalu, Y., Alamneh, A. A., Alemayehu, W., Alfaar, A. S., Alipour, V., Anbesu, E. W., Androudi, S., Arabloo, J., Arditi, A., Asaad, M., Bagli, E., Baig, A. A., Bärnighausen, T. W., Battaglia Parodi, M., Bhagavathula, A. S., Bhardwaj, N., Bhardwaj, P., Bhattacharyya, K., Bijani, A., Bikbov, M., Bottone, M., Braithwaite, T., Bron, A. M., Butt, Z. A., Cheng, C.-Y., Chu, D.-T., Cicinelli, M. V., Coelho, J. M., Dagnew, B., Dai, X., Dana, R., Dandona, L., Dandona, R., Del Monte, M. A., Deva, J. P., Diaz, D., Djalalinia, S., Dreer, L. E., Ehrlich, J. R., Ellwein, L. B., Emamian, M. H., Fernandes, A. G., Fischer, F., Friedman, D. S., Furtado, J. M., Gaidhane, A. M., Gaidhane, S., Gazzard, G., Gebremichael, B., George, R., Ghashghaee, A., Golechha, M., Hamidi, S., Hammond, B. R., Hartnett, M. E. R., Hartono, R. K., Hay, S. I., Heidari, G., Ho, H. C., Hoang, C. L., Househ, M., Ibitoye, S. E., Ilic, I. M., Ilic, M. D., Ingram, A. D., Irvani, S. S. N., Jha, R. P., Kahloun, R., Kandel, H., Kasa, A. S., Kempen, J. H., Keramati, M., Khairallah, M., Khan, E. A., Khanna, R. C., Khatib, M. N., Kim, J. E., Kim, Y. J., Kisa, S., Kisa, A., Koyanagi, A., Kurmi, O. P., Lansingh, V. C., Leasher, J. L., Leveziel, N., Limburg, H., Majdan, M., Manafi, N., Mansouri, K., McAlinden, C., Mohammadi, S. F., Mohammadian-Hafshejani, A., Mohammadpourhodki, R., Mokdad, A. H., Moosavi, D., Morse, A. R., Naderi, M., Naidoo, K. S., Nangia, V., Nguyen, C. T., Nguyen, H. L. T., Ogundimu, K., Olagunju, A. T., Ostroff, S. M., Panda-Jonas, S., Pesudovs, K., Peto, T., Quazi Syed, Z., Rahman, M. H. U., Ramulu, P. Y., Rawaf, S., Rawaf, D. L., Reinig, N., Robin, A. L., Rossetti, L., Safi, S., Sahebkar, A., Samy, A. M., Saxena, D., Serle, J. B., Shaikh, M. A., Shen, T. T., Shibuya, K., Shin, J. I., Silva, J. C., Silvester, A., Singh, J. A., Singhal, D., Sitorus, R. S., Skiadaresi, E., Skirbekk, V., Soheili, A., Sousa, R. A. R. C., Spurlock, E. E., Stambolian, D., Taddele, B. W., Tadesse, E. G., Tahhan, N., Tareque, M. I., Topouzis, F., Tran, B. X., Travillian, R. S., Tsilimbaris, M. K., Varma, R., Virgili, G., Wang, Y. X., Wang, N., West, S. K., Wong, T. Y., Zaidi, Z., Zewdie, K. A., Jonas, J. B., & Vos, T.
- Affiliations
- Anglia Ruskin University (GB)
- University of Washington (US)
- Imperial College London (GB)
- The University of Melbourne (AU)
- UNSW Sydney (AU)
- The University of Adelaide (AU)
- Heidelberg University (DE)
- Debre Markos University (ET)
- Fred Hollows Foundation (AU)
- Gates Foundation (US)
- Samara University (ET)
- University of Thessaly (GR)
- Iran University of Medical Sciences (IR)
- University Hospital of Ioannina (GR)
- Jahrom University (IR)
- Charles University (CZ)
- Université de Bourgogne (FR)
- Singapore Eye Research Institute (SG)
- Hanoi National University of Education (VN)
- Harvard University (US)
- Ministry of Health and Medical Education (IR)
- National Institutes of Health (US)
- University of Applied Sciences Ravensburg-Weingarten (DE)
- Universidade de São Paulo (BR)
- Haramaya University (ET)
- Sankara Nethralaya (IN)
- Hamdan Bin Mohammed Smart University (AE)
- University of Georgia (US)
- University of Utah (US)
- The University of Sydney (AU)
- Mashhad University of Medical Sciences (IR)
- Health Services Academy (PK)
- Datta Meghe Institute of Higher Education and Research (IN)
- Xiamen University (CN)
- Nova Southeastern University (US)
- Shahrekord University of Medical Sciences (IR)
- Lighthouse Guild (US)
- Duy Tan University (VN)
- Sightsavers (GB)
- McMaster University (CA)
- Maharishi Markandeshwar University, Mullana (IN)
- Johns Hopkins University (US)
- ORCID
- Bourne, Rupert
- Steinmetz, Jaimie D
- Flaxman, Seth
- Taylor, Hugh R
- Resnikoff, Serge
- Casson, Robert James
- Abdoli, Amir
- Afshin, Ashkan
- Ahmadieh, Hamid
- Akalu, Yonas
- Alamneh, Alehegn Aderaw
- Anbesu, Etsay Woldu
- Androudi, Sofia
- Arabloo, Jalal
- Arditi, Aries
- Asaad, Malke
- Bagli, Eleni
- Baig, Atif Amin
- Bärnighausen, Till Winfried
- Bhagavathula, Akshaya Srikanth
- Bhardwaj, Nikha
- Bhardwaj, Pankaj
- Bhattacharyya, Krittika
- Bijani, Ali
- Bikbov, Mukharram
- Bottone, Michele
- Braithwaite, Tasanee
- Bron, Alain M
- Butt, Zahid A
- Cheng, Ching-Yu
- Chu, Dinh-Toi
- Cicinelli, Maria Vittoria
- Dagnew, Baye
- Dai, Xiaochen
- Dana, Reza
- Dandona, Rakhi
- Djalalinia, Shirin
- Dreer, Laura E
- Ehrlich, Joshua R
- Emamian, Mohammad Hassan
- Fernandes, Arthur G
- Fischer, Florian
- Friedman, David S
- Furtado, João M
- Gaidhane, Abhay Motiramji
- Gaidhane, Shilpa
- Gazzard, Gus
- Gebremichael, Berhe
- George, Ronnie
- Ghashghaee, Ahmad
- Golechha, Mahaveer
- Hamidi, Samer
- Hartnett, Mary Elizabeth R
- Hartono, Risky Kusuma
- Hay, Simon I
- Heidari, Golnaz
- Ho, Hung Chak
- Hoang, Chi Linh
- Househ, Mowafa
- Ibitoye, Segun Emmanuel
- Ingram, April D
- Irvani, Seyed Sina Naghibi
- Jha, Ravi Prakash
- Kandel, Himal
- Kasa, Ayele Semachew
- Kempen, John H
- Khairallah, Moncef
- Khan, Ejaz Ahmad
- Khanna, Rohit C
- Khatib, Mahalaqua Nazli
- Kim, Judy E
- Kim, Yun Jin
- Koyanagi, Ai
- Kurmi, Om P
- Lansingh, Van Charles
- Leasher, Janet L
- Leveziel, Nicolas
- Manafi, Navid
- Mansouri, Kaweh
- McAlinden, Colm
- Mohammadi, Seyed Farzad
- Mohammadian-Hafshejani, Abdollah
- Mohammadpourhodki, Reza
- Mokdad, Ali H
- Moosavi, Delaram
- Morse, Alan R
- Naderi, Mehdi
- Naidoo, Kovin S
- Nangia, Vinay
- Nguyen, Cuong Tat
- Nguyen, Huong Lan Thi
- Olagunju, Andrew T
- Pesudovs, Konrad
- Rahman, Mohammad Hifz Ur
- Ramulu, Pradeep Y
- Rawaf, Salman
- Rawaf, David Laith
- Robin, Alan L
- Rossetti, Luca
- Safi, Sare
- Sahebkar, Amirhossein
- Samy, Abdallah M
- Saxena, Deepak
- Serle, Janet B
- Shaikh, Masood Ali
- Shen, Tueng T
- Shibuya, Kenji
- Shin, Jae Il
- Silva, Juan Carlos
- Singh, Jasvinder A
- Singhal, Deepika
- Sitorus, Rita S
- Skirbekk, Vegard
- Soheili, Amin
- Sousa, Raúl A R C
- Spurlock, Emma Elizabeth
- Tadesse, Eyayou Girma
- Tahhan, Nina
- Tareque, Md Ismail
- Topouzis, Fotis
- Tran, Bach Xuan
- Tsilimbaris, Miltiadis K
- Varma, Rohit
- Virgili, Gianni
- Wang, Ya Xing
- West, Sheila K
- Wong, Tien Y
- Zaidi, Zoubida
- Zewdie, Kaleab Alemayehu
- Jonas, Jost B
- Vos, Theo
- Venue
- The Lancet Global Health
- Publisher
- Elsevier BV
- Published
- 2021-02
- Volume
- 9
- Issue
- 2
- Pages
- e130-e143
- ISSN
- 2214-109X (ISSN-L)
- PMC
- PMC7820390
- OpenAlex
- W3110054227
- Cited by
- 1,431
- References
- 3
- Citations by year
- 2026: 239 · 2025: 332 · 2024: 279 · 2023: 262 · 2022: 209 · 2021: 105 · 2020: 3 · 2014: 1
- FWCI
- 21.13
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- The Lancet Global Health (publishedVersion, cc-by)
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- Funders
- Bausch and Lomb
- Research Management Centre, International Islamic University Malaysia
- University of Utah (EY018400)
- Anglia Ruskin University
- International Glaucoma Association
- Bundesministerium für Bildung und Forschung
- Sightsavers International
- Alexander von Humboldt-Stiftung
- Moorfields Eye Charity
- National Institutes of Health
- National Institute for Health and Care Research (HTA 09/104/40)
- National Eye Institute (R01EY015130, R01EY017011)
- Fight for Sight UK
- Bill and Melinda Gates Foundation
- Research to Prevent Blindness
- Universität Heidelberg
- Fight for Sight
- Brien Holden Vision Institute
- Fred Hollows Foundation
- Aerie Pharmaceuticals
- Topics
- Health Sciences › Medicine › Epidemiology › Ophthalmology and Visual Impairment Studies
- Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Keywords
- blindness, visual impairment, near vision impairment, prevalence trends, global burden of disease, blindness prevention, age-standardized prevalence, visual acuity, visual field defects, Vision 2020, eye disease epidemiology, adults aged 50 and older, children
- MeSH terms
- Global Burden of Disease, Aged, Aged, 80 and over, Blindness, Cataract, Eye Diseases, Female, Forecasting, Glaucoma, Humans, Macular Degeneration, Male, Middle Aged, Presbyopia, Visual Acuity, Global Health, Vision, Low
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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