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  • Global Trends in Childhood Vision Loss

    By Lynda Seminara
    Selected by Russell N. Van Gelder, MD, PhD
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    Journal Highlights

    Ophthalmology, June 2023

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    In a trend analysis of demographics, Liu et al. looked at global, regional, and national burdens of vision loss in the pediatric population. They found that worldwide prevalence declined over the 30-year timeline, due mainly to reductions in refractive disorder. The number of years living with disability (YLD) due to vision loss de­creased from 44.5 in 1990 to 40.2 in 2019. However, the prevalence of near-vision loss climbed signifi­cantly in nearly all age groups.

    For this work, the authors gathered 1990-2019 data on the burden of vision loss and blindness from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019). The relevant GBD category includes vision loss due to refractive errors, near-vision loss, and other eye diseases. The GBD 2019 definition of vision loss (Snellen VA <6/18) was used for the analysis. Severity was classified as 1) blindness, defined as VA <3/60 or <10% visual field around central fixation; 2) severe vision loss, defined as VA ≥3/60 and <6/60; 3) moderate vision loss, defined as VA ≥6/60 and <6/18; or 4) near-vision loss, defined as near VA <6/12 distance equivalent. Parameters used to estimate the burden of vision loss were case numbers, rates per 100,000 population, and average annual percentage changes (AAPCs) in prevalence rates and YLD. Data also were analyzed by sex and age group (<5, 5-9, 10-14, and 15-19).

    According to the trend analysis, the prevalence of vision loss declined glob­ally over time, from 1,091.4 per 100,000 in 1990 (95% uncertainty interval [UI], 895.2-1,326.1; AAPC, –0.3) to 1,036.9 per 100,000 in 2019 (95% UI, 847.8- 1,265.9; AAPC, –0.2). YLD decreased from 44.5 in 1990 (95% UI, 28.1-66.5; AAPC, –0.5) to 40.2 in 2019 (95% UI, 25.1-60.7, AAPC: –0.4). On the con­trary, near-vision loss became much more prevalent in all age groups except the youngest. Globally, boys fared better than girls. In countries with a low or mid sociodemographic index, the prev­alence rate and YLD declined greatly. In higher-income countries, there were large increases in both parameters.

    Global efforts in recent decades have markedly decreased the burden of childhood vision loss, said the authors, who noted that expanding screening coverage and boosting quality control should reduce the burden further. They stressed the need to address the grow­ing prevalence of near-vision loss.

    The original article can be found here.