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Background To describe the prevalence and causes of visual impairment and blindness in North Africa and the Middle East (NAME) in 1990 and 2010. Methods Based on a systematic review of medical literature, we examined prevalence and causes of moderate and severe vision impairment (MSVI; presenting visual acuity <6/18, =3/60) and blindness (presenting visual acuity <3/60). Results In NAME, the age-standardised prevalence of blindness decreased from 2.1% to 1.1% and MSVI from 7.1% to 4.5%. In 2010, 3.119 million people were blind, and 13.700 million had MSVI. Women were generally more often affected than men. Main causes of blindness were cataract, uncorrected refractive error, macular degeneration and glaucoma. Main causes of MSVI were cataract and uncorrected refractive errors. Proportions of blindness and MSVI from trachoma significantly decreased. Conclusions Although the absolute numbers of people with blindness and MSVI increased from 1990 to 2010, the overall age-standardised prevalence of blindness and MSVI among all ages and among those aged 50 years and older decreased significantly ( p<0.05). Cataract and uncorrected refractive error were the major causes of blindness and MSVI. [ABSTRACT FROM AUTHOR]

Background: To assess the prevalence and causes of vision impairment in North Africa and the Middle East (NAME) from 1990 to 2015 and to forecast projections for 2020., Methods: Based on a systematic review of medical literature, the prevalence of blindness (presenting visual acuity (PVA) <3/60 in the better eye), moderate and severe vision impairment (MSVI; PVA <6/18 but ≥3/60) and mild vision impairment (PVA <6/12 but ≥6/18) was estimated for 2015 and 2020., Results: The age-standardised prevalence of blindness and MSVI for all ages and genders decreased from 1990 to 2015, from 1.72 (0.53-3.13) to 0.95% (0.32%-1.71%), and from 6.66 (3.09-10.69) to 4.62% (2.21%-7.33%), respectively, with slightly higher figures for women than men. Cataract was the most common cause of blindness in 1990 and 2015, followed by uncorrected refractive error. Uncorrected refractive error was the leading cause of MSVI in the NAME region in 1990 and 2015, followed by cataract. A reduction in the proportions of blindness and MSVI due to cataract, corneal opacity and trachoma is predicted by 2020. Conversely, an increase in the proportion of blindness attributable to uncorrected refractive error, glaucoma, age-related macular degeneration and diabetic retinopathy is expected., Conclusions: In 2015 cataract and uncorrected refractive error were the major causes of vision loss in the NAME region. Proportions of vision impairment from cataract, corneal opacity and trachoma are expected to decrease by 2020, and those from uncorrected refractive error, glaucoma, diabetic retinopathy and age-related macular degeneration are predicted to increase by 2020., Competing Interests: Competing interests: JBJ: consultant for Mundipharma (Cambridge, UK); patent holder with Biocompatibles UK (Farnham, Surrey, UK) (Title: Treatment of eye diseases using encapsulated cells encoding and secreting neuroprotective factor and/or antiangiogenic factor; patent number: 20120263794) and patent application with the University of Heidelberg (Heidelberg, Germany) (Title: Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia; Europäische Patentanmeldung 15 000 771.4). JHK: consultant for Gilead and Santen. SR: consultant for Brien Holden Vision Institute., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)