Eye care research informs major WHO report

New research published today in The Lancet Global Health reveals that less than half of people over 50 worldwide have received spectacles or contact lenses needed to correct refractive error, the world’s most common visual complaint – and informs a major World Health Organisation (WHO) report on eye care.

Uncorrected refractive error refers to visual conditions such as presbyopia, myopia, hyperopia and astigmatism that can be treated with simple interventions such as spectacles or contact lenses. It is the leading cause of moderate and severe distance vision impairment worldwide, affecting at least 157 million people in 2020.

The new study was carried out by the Vision Loss Expert Group, led by Professor Rupert Bourne, of Anglia Ruskin University (ARU) and Cambridge University Hospitals. Researchers analysed data from 169 different studies from across the world to calculate figures in several defined regions for treatment coverage of distance and near refractive error.

The research found that while adequate treatment coverage of distance refractive error – conditions such as myopia, astigmatism, or moderate to severe hyperopia – had increased by 19% since 2000, only 43% of all adults over the age of 50 are receiving simple treatments for these conditions, with the number at 21% coverage for those with problems of nearsight, known as presbyopia.

Treatment coverage for distance refractive error varied worldwide, from 79% in the defined ‘high income’ region, including countries such as the United States, to just 5.7% in Sub-Saharan Africa.

The study also highlighted a gender gap in all defined regions of the world, with lower levels of coverage in women.

The WHO aims to increase the treatment coverage for distance refractive error by 40 percentage points by 2030, and Professor Bourne will present the evidence from the study at the United Nations (UN) Headquarters in New York City on Wednesday (12 October) during the launch of the first WHO Report of the 2030 targets of effective coverage of eye care.

Professor Bourne, Professor of Ophthalmology at Anglia Ruskin University (ARU) and Consultant Ophthalmic Surgeon at Cambridge University Hospitals, said: “There is growing evidence that improving eye health and preventing vision impairment can directly contribute to the achievement of many other Sustainable Development Goals (SDGs) such as the reduction of poverty and improvements in work productivity, education, and equity.

“This has been recognised by the United Nations and our research has been able to inform targets for the WHO to improve treatment outcomes across the world.

“There are multiple social and cultural reasons that influence coverage of treatment for refractive error. Of these, the lower coverage among women is most striking. We believe that differences in access to healthcare and take-up of services are likely to be the main reasons for this gender inequality.

“It is clear that if we are to meet these WHO targets, the quality and quantity of refractive services across the world must be improved.”

The research was funded by the WHO, Sightsavers, The Fred Hollows Foundation, Fondation Thea, Brien Holden Vision Institute and Lions Clubs International Foundation.

The full paper can be read here: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(22)00433-8/fulltext