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Causes of Vision Loss Worldwide, 1990–2010: A Systematic Analysis


Dr Prof Rupert R A Bourne MD, Gretchen A Stevens DSc, Richard A White PhD, Jennifer L Smith MSc, Seth R Flaxman BA, Holly Price PhD, Prof Jost B Jonas MD, Prof Jill Keeffe PhD, Janet Leasher OD, Kovin Naidoo PhD, Prof Konrad Pesudovs PhD, Prof Serge Resnikoff PhD, Prof Hugh R Taylor MD on behalf of the Vision Loss Expert Group


Bill & Melinda Gates Foundation, Fight for Sight, Fred Hollows Foundation, and Brien Holden Vision Institute.




The Lancet Global Health


  • Data on causes of vision impairment and blindness are important for development of public health policies, but comprehensive analysis of change in prevalence over time is lacking.

  • The study is a systematic analysis of published and unpublished data on the causes of blindness (visual acuity in the better eye less than 3/60) and moderate and severe vision impairment ([MSVI] visual acuity in the better eye less than 6/18 but at least 3/60) from 1980 to 2012.

  • The proportions of overall vision impairment attributable to cataract, glaucoma, macular degeneration, diabetic retinopathy, trachoma, and uncorrected refractive error in 1990–2010 were estimated by age, geographical region, and year.

  • In 2010, 65% of 32·4 million blind people and 76% of 191 million people with MSVI worldwide had a preventable or treatable cause, compared with 68%) of 31·8 million and 80% of 172 million in 1990. Leading causes worldwide in 1990 and 2010 for blindness were cataract (39% and 33%, respectively), uncorrected refractive error (20% and 21%), and macular degeneration (5% and 7%), and for MSVI were uncorrected refractive error (51% and 53%), cataract (26% and 18%), and macular degeneration (2% and 3%).

  • Causes of blindness varied substantially by region. Worldwide and in all regions more women than men were blind or had MSVI due to cataract and macular degeneration.

  • The differences and temporal changes we found in causes of blindness and MSVI have implications for planning and resource allocation in eye care.