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1. Effective refractive error coverage in adults aged 50 years and older: estimates from population-based surveys in 61 countries

Author: Bourne, RRA, Cicinelli, MV, Sedighi, T, Tapply, IH, McCormick, I, Jonas, JB, Congdon, NG, Ramke, J, Naidoo, KS ; https://orcid.org/0000-0001-8261-9779, Fricke, TR ; https://orcid.org/0000-0001-8087-6835, Burton, MJ, Müller, A, Bikbov, MM, Furtado, JM, Kyari, F, He, M, Wang, YX, Vijaya, L, Nangia, V, Brian, G, Emamian, MH, Fotouhi, A, Hashemi, H, Khandekar, RB, Marmamula, S ; https://orcid.org/0000-0003-1716-9809, Salomão, S, George, R, Kazakbaeva, G, Braithwaite, T, Casson, RJ, Iwase, A, Gupta, N, Abdianwall, MH, Varma, R, Wong, TY, Wang, N, Taylor, HR, Flaxman, SR, Keel, S, Resnikoff, S ; https://orcid.org/0000-0002-5866-4446, Bron, A, Cheng, CY, Fernandes, A, Friedman, D, Gazzard, A, Kahloun, R, Kempen, J, Khairallah, M, Lansingh, VC, Leasher, J, Leveziel, N, Limburg, H, Nowak, M, Pesudovs, K ; https://orcid.org/0000-0002-6322-9369, Peto, T, Rossetti, L, Tahhan, N, Alemayehu, W, Arditi, A, Dana, R, Del Monte, M, Deva, J, Dreer, L, Ehrlich, J, Ellwein, L, Hammond, B, Hartnett, ME, Ingram, A, Khanna, R ; https://orcid.org/0000-0002-8698-5562, Kim, J, Lim, J, Morse, A, Musch, D, Parodi, MB, Ramulu, P, Robin, A, Serle, J, Shen, T, Sitorus, RS, Stambolian, D, Topouzis, F, Tsilimbaris, M, Virgili, G, West, S, Ababora, JK, AlSawahli, H, Andriamanjato, HH, Barrenechea, R, Batlle, JF, Burnett, AM ; https://orcid.org/0000-0003-3772-6625, Finger, RP, Gallarreta, M, Gomez-Bastar, PA, Gurung, R, Jain, E, Kabona, GE, Kalua, K, Kandeke, L, Karimurio, J, Kikira, SA, Bourne, RRA, Cicinelli, MV, Sedighi, T, Tapply, IH, McCormick, I, Jonas, JB, Congdon, NG, Ramke, J, Naidoo, KS ; https://orcid.org/0000-0001-8261-9779, Fricke, TR ; https://orcid.org/0000-0001-8087-6835, Burton, MJ, Müller, A, Bikbov, MM, Furtado, JM, Kyari, F, He, M, Wang, YX, Vijaya, L, Nangia, V, Brian, G, Emamian, MH, Fotouhi, A, Hashemi, H, Khandekar, RB, Marmamula, S ; https://orcid.org/0000-0003-1716-9809, Salomão, S, George, R, Kazakbaeva, G, Braithwaite, T, Casson, RJ, Iwase, A, Gupta, N, Abdianwall, MH, Varma, R, Wong, TY, Wang, N, Taylor, HR, Flaxman, SR, Keel, S, Resnikoff, S ; https://orcid.org/0000-0002-5866-4446, Bron, A, Cheng, CY, Fernandes, A, Friedman, D, Gazzard, A, Kahloun, R, Kempen, J, Khairallah, M, Lansingh, VC, Leasher, J, Leveziel, N, Limburg, H, Nowak, M, Pesudovs, K ; https://orcid.org/0000-0002-6322-9369, Peto, T, Rossetti, L, Tahhan, N, Alemayehu, W, Arditi, A, Dana, R, Del Monte, M, Deva, J, Dreer, L, Ehrlich, J, Ellwein, L, Hammond, B, Hartnett, ME, Ingram, A, Khanna, R ; https://orcid.org/0000-0002-8698-5562, Kim, J, Lim, J, Morse, A, Musch, D, Parodi, MB, Ramulu, P, Robin, A, Serle, J, Shen, T, Sitorus, RS, Stambolian, D, Topouzis, F, Tsilimbaris, M, Virgili, G, West, S, Ababora, JK, AlSawahli, H, Andriamanjato, HH, Barrenechea, R, Batlle, JF, Burnett, AM ; https://orcid.org/0000-0003-3772-6625, Finger, RP, Gallarreta, M, Gomez-Bastar, PA, Gurung, R, Jain, E, Kabona, GE, Kalua, K, Kandeke, L, Karimurio, J, and Kikira, SA
Abstract: Background: In 2021, WHO Member States endorsed a global target of a 40-percentage-point increase in effective refractive error coverage (eREC; with a 6/12 visual acuity threshold) by 2030. This study models global and regional estimates of eREC as a baseline for the WHO initiative. Methods: The Vision Loss Expert Group analysed data from 565 448 participants of 169 population-based eye surveys conducted since 2000 to calculate eREC (met need/[met need + undermet need + unmet need]). A binary logistic regression model was used to estimate eREC by Global Burden of Disease (GBD) Study super region among adults aged 50 years and older. Findings: In 2021, distance eREC was 79·1% (95% CI 72·4–85·0) in the high-income super region; 62·1% (54·7–68·8) in north Africa and Middle East; 49·5% (45·0–54·0) in central Europe, eastern Europe, and central Asia; 40·0% (31·7–48·2) in southeast Asia, east Asia, and Oceania; 34·5% (29·4–40·0) in Latin America and the Caribbean; 9·0% (6·5–12·0) in south Asia; and 5·7% (3·1–9·0) in sub-Saharan Africa. eREC was higher in men and reduced with increasing age. Global distance eREC increased from 2000 to 2021 by 19·0%. Global near vision eREC for 2021 was 20·5% (95% CI 17·8–24·4). Interpretation: Over the past 20 years, distance eREC has increased in each super region yet the WHO target will require substantial improvements in quantity and quality of refractive services in particular for near vision impairment. Funding: WHO, Sightsavers, The Fred Hollows Foundation, Fondation Thea, Brien Holden Vision Institute, Lions Clubs International Foundation.
Published: 2022

2. Evaluating multidisciplinary glaucoma care: visual field progression and loss of sight year analysis in the community vs hospital setting

Author: Mushtaq, Y, Panchasara, B, Nassehzadehtabriz, N, Lim, HK, Mushtaq, M, Kean, J, Farrell, S, Bourne, RRA, Shahid, H, Khatib, TZ, Martin, KR, Mushtaq, Y, Panchasara, B, Nassehzadehtabriz, N, Lim, HK, Mushtaq, M, Kean, J, Farrell, S, Bourne, RRA, Shahid, H, Khatib, TZ, and Martin, KR
Abstract: BACKGROUND: A variety of shared care models have been developed, which aim to stratify glaucoma patients according to risk of disease progression. However, there is limited published data on the rate of glaucoma progression in the hospital vs community setting. Here we aimed to compare rates of glaucomatous visual field progression in the Cambridge Community Optometrist Glaucoma Scheme (COGS) and Addenbrooke's Hospital Glaucoma Clinic (AGC). METHODS: A retrospective comparative cohort review was performed. Patients with five or more visual field tests were included. Zeiss Forum software was used to calculate the MD progression rate (dB/year). Loss of sight years (LSY) were also calculated for both COGS and AGC. RESULTS: Overall, 8465 visual field tests from 854 patients were reviewed. In all, 362 eyes from the AGC group and 210 eyes from COGS were included. The MD deterioration rate was significantly lower in the COGS patients compared with the AGC group (-0.1 vs -0.3 dB/year; p < 0.0001). No patients in the COGS group were predicted to become blind within their lifetime by LSY analysis. Fifteen patients were at risk in the AGC group. CONCLUSION: This service evaluation shows that COGS is an effective scheme to stratify lower risk glaucoma patients, increasing the capacity within hospital eye services. COGS patients have a lower rate of visual field deterioration compared to AGC patients. Effective communication between community and tertiary schemes is essential to facilitate transfer of patients requiring further hospital management reliably and efficiently, with the potential for low-risk patients to be followed safely in the community.
Published: 2022

3. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: The Right to Sight: An analysis for the Global Burden of Disease Study

Author: Bourne, RRA, Steinmetz, JD, Saylan, M, Mersha, AM, Weldemariam, AH, Wondmeneh, TG, Sreeramareddy, CT, Pinheiro, M, Yaseri, M, Yu, C, Zastrozhin, MS, Zastrozhina, A, Zhang, ZJ, Zimsen, SRM, Yonemoto, N, Tsegaye, GW, Vu, GT, Vongpradith, A, Renzaho, AMN, Sorrie, MB, Shaheen, AA, Shiferaw, WS, Skryabin, VY, Skryabina, AA, Saya, GK, Rahimi-Movaghar, V, Shigematsu, M, Sahraian, MA, Naderifar, H, Sabour, S, Rathi, P, Sathian, B, Miller, TR, Rezapour, A, Rawal, L, Pham, HQ, Parekh, U, Podder, V, Onwujekwe, OE, Pasovic, M, Otstavnov, N, Negash, H, Pawar, S, Naimzada, MD, Al Montasir, A, Ogbo, FA, Owolabi, MO, Pakshir, K, Mohammad, Y, Moni, MA, Nunez-Samudio, V, Mulaw, GF, Naveed, M, Maleki, S, Michalek, IM, Misra, S, Swamy, SN, Mohammed, JA, Flaxman, S, Park, EC, Briant, PS, Meles, GG, Hayat, K, Landires, I, Kim, GR, Liu, X, LeGrand, KE, Taylor, HR, Kunjathur, SM, Khoja, TAM, Bicer, BK, Khalilov, R, Hashi, A, Kayode, GA, Carneiro, VLA, Kavetskyy, T, Kosen, S, Kulkarni, V, Holla, R, Kalhor, R, Jayaram, S, Islam, Shariful, Gilani, SA, Eskandarieh, S, Molla, MD, Itumalla, R, Farzadfar, F, Congdon, NG, Elhabashy, HR, Elayedath, R, Couto, RAS, Dervenis, N, Cromwell, EA, Dahlawi, SMA, Resnikoff, S, Casson, RJ, Abdoli, A, Choi, JYJ, Dos Santos, FLC, Abrha, WA, Bourne, RRA, Steinmetz, JD, Saylan, M, Mersha, AM, Weldemariam, AH, Wondmeneh, TG, Sreeramareddy, CT, Pinheiro, M, Yaseri, M, Yu, C, Zastrozhin, MS, Zastrozhina, A, Zhang, ZJ, Zimsen, SRM, Yonemoto, N, Tsegaye, GW, Vu, GT, Vongpradith, A, Renzaho, AMN, Sorrie, MB, Shaheen, AA, Shiferaw, WS, Skryabin, VY, Skryabina, AA, Saya, GK, Rahimi-Movaghar, V, Shigematsu, M, Sahraian, MA, Naderifar, H, Sabour, S, Rathi, P, Sathian, B, Miller, TR, Rezapour, A, Rawal, L, Pham, HQ, Parekh, U, Podder, V, Onwujekwe, OE, Pasovic, M, Otstavnov, N, Negash, H, Pawar, S, Naimzada, MD, Al Montasir, A, Ogbo, FA, Owolabi, MO, Pakshir, K, Mohammad, Y, Moni, MA, Nunez-Samudio, V, Mulaw, GF, Naveed, M, Maleki, S, Michalek, IM, Misra, S, Swamy, SN, Mohammed, JA, Flaxman, S, Park, EC, Briant, PS, Meles, GG, Hayat, K, Landires, I, Kim, GR, Liu, X, LeGrand, KE, Taylor, HR, Kunjathur, SM, Khoja, TAM, Bicer, BK, Khalilov, R, Hashi, A, Kayode, GA, Carneiro, VLA, Kavetskyy, T, Kosen, S, Kulkarni, V, Holla, R, Kalhor, R, Jayaram, S, Islam, Shariful, Gilani, SA, Eskandarieh, S, Molla, MD, Itumalla, R, Farzadfar, F, Congdon, NG, Elhabashy, HR, Elayedath, R, Couto, RAS, Dervenis, N, Cromwell, EA, Dahlawi, SMA, Resnikoff, S, Casson, RJ, Abdoli, A, Choi, JYJ, Dos Santos, FLC, and Abrha, WA
Published: 2021

4. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study

Author: Steinmetz, JD, Bourne, RRA, Briant, PS, Flaxman, S, Taylor, HR, Jonas, JB, Abdoli, A, Abrha, WA, Abualhasan, A, Abu-Gharbieh, E, Adal, TG, Afshin, A, Ahmadieh, H, Alemayehu, W, Alemzadeh, SA, Alfaar, AS, Alipour, V, Androudi, S, Arabloo, J, Arditi, A, Aregawi, BB, Arrigo, A, Ashbaugh, C, Ashrafi, E, Atnafu, DD, Bagli, E, Baig, AA, Barnighausen, TW, Parodi, MB, Beheshti, M, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bijani, A, Bikbov, M, Bottone, M, Braithwaite, T, Bron, AM, Nagaraja, SB, Butt, ZA, dos Santos, FLC, Carneiro, VLA, Casson, RJ, Cheng, C-Y, Choi, J-YJ, Chu, D-T, Cicinelli, MV, Coelho, JM, Congdon, NG, Couto, RAS, Cromwell, EA, Dahlawi, SMA, Dai, X, Dana, R, Dandona, L, Dandona, R, Del Monte, MA, Molla, MD, Dervenis, N, Desta, AA, Deva, JP, Diaz, D, Djalalinia, S, Ehrlich, JR, Elayedath, R, Elhabashy, HR, Ellwein, LB, Emamian, MH, Eskandarieh, S, Farzadfar, F, Fernandes, AG, Fischer, F, Friedman, DS, Furtado, JM, Gaidhane, S, Gazzard, G, Gebremichael, B, George, R, Ghashghaee, A, Gilani, SA, Golechha, M, Hamidi, S, Hammond, BR, Hartnett, MER, Hartono, RK, Hashi, A, Hay, S, Hayat, K, Heidari, G, Ho, HC, Holla, R, Househ, M, Huang, JJ, Ibitoye, SE, Ilic, IM, Ilic, MD, Ingram, AD, Irvani, SSN, Islam, SMS, Itumalla, R, Jayaram, S, Jha, RP, Kahloun, R, Kalhor, R, Kandel, H, Kasa, AS, Kavetskyy, T, Kayode, GA, Kempen, JH, Khairallah, M, Khalilov, R, Khan, EA, Khanna, RC, Khatib, MN, Khoja, TAM, Kim, GR, Kim, JE, Kim, YJ, Kisa, A, Kisa, S, Kosen, S, Koyanagi, A, Bicer, BK, Kulkarni, V, Kurmi, OP, Landires, I, Lansingh, VC, Leasher, JL, LeGrand, KE, Leveziel, N, Limburg, H, Liu, X, Kunjathur, SM, Maleki, S, Manafi, N, Mansouri, K, McAlinden, C, Meles, GG, Mersha, AM, Michalek, IM, Miller, TR, Misra, S, Mohammad, Y, Mohammadi, SF, Mohammed, JA, Mokdad, AH, Moni, MA, Al Montasir, A, Morse, AR, Mulaw, GF, Naderi, M, Naderifar, H, Naidoo, KS, Naimzada, MD, Nangia, V, Swamy, SN, Naveed, M, Negash, H, Huong, LTN, Nunez-Samudio, V, Ogbo, FA, Ogundimu, K, Olagunju, AT, Onwujekwe, OE, Otstavnov, N, Owolabi, MO, Pakshir, K, Panda-Jonas, S, Parekh, U, Park, E-C, Pasovic, M, Pawar, S, Pesudovs, K, Peto, T, Pham, HQ, Pinheiro, M, Podder, V, Rahimi-Movaghar, V, Rahman, MHU, Ramulu, PY, Rathi, P, Rawaf, DL, Rawaf, S, Rawal, L, Reinig, N, Renzaho, AMN, Rezapour, A, Robin, AL, Rossetti, L, Sabour, S, Safi, S, Sahebkar, A, Sahraian, MA, Samy, AM, Sathian, B, Saya, GK, Saylan, M, Shaheen, AA, Shaikh, MA, Shen, TT, Shibuya, K, Shiferaw, WS, Shigematsu, M, Shin, JI, Silva, JC, Silvester, A, Singh, JA, Singhal, D, Sitorus, RS, Skiadaresi, E, Skryabin, VY, Skryabina, AA, Soheili, A, Sorrie, MB, Sousa, RARC, Sreeramareddy, CT, Stambolian, D, Tadesse, EG, Tahhan, N, Tareque, MI, Topouzis, F, Bach, XT, Tsegaye, GW, Tsilimbaris, MK, Varma, R, Virgili, G, Vongpradith, A, Vu, GT, Wang, YX, Wang, N, Weldemariam, AH, West, SK, Wondmeneh, TG, Wong, TY, Yaseri, M, Yonemoto, N, Yu, C, Zastrozhin, MS, Zastrozhina, A, Zhang, Z-J, Zimsen, SRM, Resnikoff, S, Vos, T, Steinmetz, JD, Bourne, RRA, Briant, PS, Flaxman, S, Taylor, HR, Jonas, JB, Abdoli, A, Abrha, WA, Abualhasan, A, Abu-Gharbieh, E, Adal, TG, Afshin, A, Ahmadieh, H, Alemayehu, W, Alemzadeh, SA, Alfaar, AS, Alipour, V, Androudi, S, Arabloo, J, Arditi, A, Aregawi, BB, Arrigo, A, Ashbaugh, C, Ashrafi, E, Atnafu, DD, Bagli, E, Baig, AA, Barnighausen, TW, Parodi, MB, Beheshti, M, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bijani, A, Bikbov, M, Bottone, M, Braithwaite, T, Bron, AM, Nagaraja, SB, Butt, ZA, dos Santos, FLC, Carneiro, VLA, Casson, RJ, Cheng, C-Y, Choi, J-YJ, Chu, D-T, Cicinelli, MV, Coelho, JM, Congdon, NG, Couto, RAS, Cromwell, EA, Dahlawi, SMA, Dai, X, Dana, R, Dandona, L, Dandona, R, Del Monte, MA, Molla, MD, Dervenis, N, Desta, AA, Deva, JP, Diaz, D, Djalalinia, S, Ehrlich, JR, Elayedath, R, Elhabashy, HR, Ellwein, LB, Emamian, MH, Eskandarieh, S, Farzadfar, F, Fernandes, AG, Fischer, F, Friedman, DS, Furtado, JM, Gaidhane, S, Gazzard, G, Gebremichael, B, George, R, Ghashghaee, A, Gilani, SA, Golechha, M, Hamidi, S, Hammond, BR, Hartnett, MER, Hartono, RK, Hashi, A, Hay, S, Hayat, K, Heidari, G, Ho, HC, Holla, R, Househ, M, Huang, JJ, Ibitoye, SE, Ilic, IM, Ilic, MD, Ingram, AD, Irvani, SSN, Islam, SMS, Itumalla, R, Jayaram, S, Jha, RP, Kahloun, R, Kalhor, R, Kandel, H, Kasa, AS, Kavetskyy, T, Kayode, GA, Kempen, JH, Khairallah, M, Khalilov, R, Khan, EA, Khanna, RC, Khatib, MN, Khoja, TAM, Kim, GR, Kim, JE, Kim, YJ, Kisa, A, Kisa, S, Kosen, S, Koyanagi, A, Bicer, BK, Kulkarni, V, Kurmi, OP, Landires, I, Lansingh, VC, Leasher, JL, LeGrand, KE, Leveziel, N, Limburg, H, Liu, X, Kunjathur, SM, Maleki, S, Manafi, N, Mansouri, K, McAlinden, C, Meles, GG, Mersha, AM, Michalek, IM, Miller, TR, Misra, S, Mohammad, Y, Mohammadi, SF, Mohammed, JA, Mokdad, AH, Moni, MA, Al Montasir, A, Morse, AR, Mulaw, GF, Naderi, M, Naderifar, H, Naidoo, KS, Naimzada, MD, Nangia, V, Swamy, SN, Naveed, M, Negash, H, Huong, LTN, Nunez-Samudio, V, Ogbo, FA, Ogundimu, K, Olagunju, AT, Onwujekwe, OE, Otstavnov, N, Owolabi, MO, Pakshir, K, Panda-Jonas, S, Parekh, U, Park, E-C, Pasovic, M, Pawar, S, Pesudovs, K, Peto, T, Pham, HQ, Pinheiro, M, Podder, V, Rahimi-Movaghar, V, Rahman, MHU, Ramulu, PY, Rathi, P, Rawaf, DL, Rawaf, S, Rawal, L, Reinig, N, Renzaho, AMN, Rezapour, A, Robin, AL, Rossetti, L, Sabour, S, Safi, S, Sahebkar, A, Sahraian, MA, Samy, AM, Sathian, B, Saya, GK, Saylan, M, Shaheen, AA, Shaikh, MA, Shen, TT, Shibuya, K, Shiferaw, WS, Shigematsu, M, Shin, JI, Silva, JC, Silvester, A, Singh, JA, Singhal, D, Sitorus, RS, Skiadaresi, E, Skryabin, VY, Skryabina, AA, Soheili, A, Sorrie, MB, Sousa, RARC, Sreeramareddy, CT, Stambolian, D, Tadesse, EG, Tahhan, N, Tareque, MI, Topouzis, F, Bach, XT, Tsegaye, GW, Tsilimbaris, MK, Varma, R, Virgili, G, Vongpradith, A, Vu, GT, Wang, YX, Wang, N, Weldemariam, AH, West, SK, Wondmeneh, TG, Wong, TY, Yaseri, M, Yonemoto, N, Yu, C, Zastrozhin, MS, Zastrozhina, A, Zhang, Z-J, Zimsen, SRM, Resnikoff, S, and Vos, T
Abstract: BACKGROUND: Many causes of vision impairment can be prevented or treated. With an ageing global population, the demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in avoidable vision impairment, defined as cataract and undercorrected refractive error. METHODS: We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. We fitted hierarchical models to estimate prevalence (with 95% uncertainty intervals [UIs]) of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness (<3/60 or less than 10° visual field around central fixation) by cause, age, region, and year. Because of data sparsity at younger ages, our analysis focused on adults aged 50 years and older. FINDINGS: Global crude prevalence of avoidable vision impairment and blindness in adults aged 50 years and older did not change between 2010 and 2019 (percentage change -0·2% [95% UI -1·5 to 1·0]; 2019 prevalence 9·58 cases per 1000 people [95% IU 8·51 to 10·8], 2010 prevalence 96·0 cases per 1000 people [86·0 to 107·0]). Age-standardised prevalence of avoidable blindness decreased by -15·4% [-16·8 to -14·3], while avoidable MSVI showed no change (0·5% [-0·8 to 1·6]). However, the number of cases increased for both avoidable blindness (10·8% [8·9 to 12·4]) and MSVI (31·5% [30·0 to 33·1]). The leading global causes of blindness in those aged 50 years and older in 2020 were cataract (15·2 million cases [9% IU 12·7-18·0]), followed by glaucoma (3·6 million cases [2·8-4·4]), undercorrected refractive error (2·3 million cases [1·8-2·8]), age-related macular degeneration (1·8 million cases [1·3-2·4]), and diabetic retinopathy (0·86 mill
Published: 2021

5. Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study

Author: Bourne, RRA, Steinmetz, JD, Flaxman, S, Briant, PS, Taylor, HR, Resnikoff, S, Casson, RJ, Abdoli, A, Abu-Gharbieh, E, Afshin, A, Ahmadieh, H, Akalu, Y, Alamneh, AA, Alemayehu, W, Alfaar, AS, Alipour, V, Anbesu, EW, Androudi, S, Arabloo, J, Arditi, A, Asaad, M, Bagli, E, Baig, AA, Barnighausen, TW, Parodi, MB, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bijani, A, Bikbov, M, Bottone, M, Braithwaite, T, Bron, AM, Butt, ZA, Cheng, C-Y, Chu, D-T, Cicinelli, MV, Coelho, JM, Dagnew, B, Dai, X, Dana, R, Dandona, L, Dandona, R, Del Monte, MA, Deva, JP, Diaz, D, Djalalinia, S, Dreer, LE, Ehrlich, JR, Ellwein, LB, Emamian, MH, Fernandes, AG, Fischer, F, Friedman, DS, Furtado, JM, Gaidhane, AM, Gaidhane, S, Gazzard, G, Gebremichael, B, George, R, Ghashghaee, A, Golechha, M, Hamidi, S, Hammond, BR, Hartnett, MER, Hartono, RK, Hay, S, Heidari, G, Ho, HC, Chi, LH, Househ, M, Ibitoye, SE, Ilic, IM, Ilic, MD, Ingram, AD, Irvani, SSN, Jha, RP, Kahloun, R, Kandel, H, Kasa, AS, Kempen, JH, Keramati, M, Khairallah, M, Khan, EA, Khanna, RC, Khatib, MN, Kim, JE, Kim, YJ, Kisa, A, Kisa, S, Koyanagi, A, Kurmi, OP, Lansingh, VC, Leasher, JL, Leveziel, N, Limburg, H, Majdan, M, Manafi, N, Mansouri, K, McAlinden, C, Mohammadi, SF, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mokdad, AH, Moosavi, D, Morse, AR, Naderi, M, Naidoo, KS, Nangia, V, Cuong, TN, Huong, LTN, Ogundimu, K, Olagunju, AT, Ostroff, SM, Panda-Jonas, S, Pesudovs, K, Peto, T, Syed, ZQ, Rahman, MHU, Ramulu, PY, Rawaf, DL, Rawaf, S, Reinig, N, Robin, AL, Rossetti, L, Safi, S, Sahebkar, A, Samy, AM, Saxena, D, Serle, JB, Shaikh, MA, Shen, TT, Shibuya, K, Shin, JI, Silva, JC, Silvester, A, Singh, JA, Singhal, D, Sitorus, RS, Skiadaresi, E, Skirbekk, V, Soheili, A, Sousa, RARC, Spurlock, EE, Stambolian, D, Taddele, BW, Tadesse, EG, Tahhan, N, Tareque, MI, Topouzis, F, Bach, XT, Travillian, RS, Tsilimbaris, MK, Varma, R, Virgili, G, Wang, N, Wang, YX, West, SK, Wong, TY, Zaidi, Z, Zewdie, KA, Jonas, JB, Vos, T, Bourne, RRA, Steinmetz, JD, Flaxman, S, Briant, PS, Taylor, HR, Resnikoff, S, Casson, RJ, Abdoli, A, Abu-Gharbieh, E, Afshin, A, Ahmadieh, H, Akalu, Y, Alamneh, AA, Alemayehu, W, Alfaar, AS, Alipour, V, Anbesu, EW, Androudi, S, Arabloo, J, Arditi, A, Asaad, M, Bagli, E, Baig, AA, Barnighausen, TW, Parodi, MB, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bijani, A, Bikbov, M, Bottone, M, Braithwaite, T, Bron, AM, Butt, ZA, Cheng, C-Y, Chu, D-T, Cicinelli, MV, Coelho, JM, Dagnew, B, Dai, X, Dana, R, Dandona, L, Dandona, R, Del Monte, MA, Deva, JP, Diaz, D, Djalalinia, S, Dreer, LE, Ehrlich, JR, Ellwein, LB, Emamian, MH, Fernandes, AG, Fischer, F, Friedman, DS, Furtado, JM, Gaidhane, AM, Gaidhane, S, Gazzard, G, Gebremichael, B, George, R, Ghashghaee, A, Golechha, M, Hamidi, S, Hammond, BR, Hartnett, MER, Hartono, RK, Hay, S, Heidari, G, Ho, HC, Chi, LH, Househ, M, Ibitoye, SE, Ilic, IM, Ilic, MD, Ingram, AD, Irvani, SSN, Jha, RP, Kahloun, R, Kandel, H, Kasa, AS, Kempen, JH, Keramati, M, Khairallah, M, Khan, EA, Khanna, RC, Khatib, MN, Kim, JE, Kim, YJ, Kisa, A, Kisa, S, Koyanagi, A, Kurmi, OP, Lansingh, VC, Leasher, JL, Leveziel, N, Limburg, H, Majdan, M, Manafi, N, Mansouri, K, McAlinden, C, Mohammadi, SF, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mokdad, AH, Moosavi, D, Morse, AR, Naderi, M, Naidoo, KS, Nangia, V, Cuong, TN, Huong, LTN, Ogundimu, K, Olagunju, AT, Ostroff, SM, Panda-Jonas, S, Pesudovs, K, Peto, T, Syed, ZQ, Rahman, MHU, Ramulu, PY, Rawaf, DL, Rawaf, S, Reinig, N, Robin, AL, Rossetti, L, Safi, S, Sahebkar, A, Samy, AM, Saxena, D, Serle, JB, Shaikh, MA, Shen, TT, Shibuya, K, Shin, JI, Silva, JC, Silvester, A, Singh, JA, Singhal, D, Sitorus, RS, Skiadaresi, E, Skirbekk, V, Soheili, A, Sousa, RARC, Spurlock, EE, Stambolian, D, Taddele, BW, Tadesse, EG, Tahhan, N, Tareque, MI, Topouzis, F, Bach, XT, Travillian, RS, Tsilimbaris, MK, Varma, R, Virgili, G, Wang, N, Wang, YX, West, SK, Wong, TY, Zaidi, Z, Zewdie, KA, Jonas, JB, and Vos, T
Abstract: 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
Published: 2021

6. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020

Author: Burton, MJ, Ramke, J, Marques, AP, Bourne, RRA, Congdon, N, Jones, I, Tong, BAMA, Arunga, S, Bachani, D, Bascaran, C, Bastawrous, A, Blanchet, K, Braithwaite, T, Buchan, JC, Cairns, J, Cama, A, Chagunda, M, Chuluunkhuu, C, Cooper, A, Crofts-Lawrence, J, Dean, WH, Denniston, AK, Ehrlich, JR, Emerson, PM, Evans, JR, Frick, KD, Friedman, DS, Furtado, JM, Gichangi, MM, Gichuhi, S, Gilbert, SS, Gurung, R, Habtamu, E, Holland, P, Jonas, JB, Keane, PA, Keay, L, Khanna, RC, Khaw, PT, Kuper, H, Kyari, F, Lansingh, VC, Mactaggart, I, Mafwiri, MM, Mathenge, W, McCormick, I, Morjaria, P, Mowatt, L, Muirhead, D, Murthy, GVS, Mwangi, N, Patel, DB, Peto, T, Qureshi, BM, Salomao, SR, Sarah, V, Shilio, BR, Solomon, AW, Swenor, BK, Taylor, HR, Wang, N, Webson, A, West, SK, Wong, TY, Wormald, R, Yasmin, S, Yusufu, M, Silva, JC, Resnikoff, S, Ravilla, T, Gilbert, CE, Foster, A, Faal, HB, Burton, MJ, Ramke, J, Marques, AP, Bourne, RRA, Congdon, N, Jones, I, Tong, BAMA, Arunga, S, Bachani, D, Bascaran, C, Bastawrous, A, Blanchet, K, Braithwaite, T, Buchan, JC, Cairns, J, Cama, A, Chagunda, M, Chuluunkhuu, C, Cooper, A, Crofts-Lawrence, J, Dean, WH, Denniston, AK, Ehrlich, JR, Emerson, PM, Evans, JR, Frick, KD, Friedman, DS, Furtado, JM, Gichangi, MM, Gichuhi, S, Gilbert, SS, Gurung, R, Habtamu, E, Holland, P, Jonas, JB, Keane, PA, Keay, L, Khanna, RC, Khaw, PT, Kuper, H, Kyari, F, Lansingh, VC, Mactaggart, I, Mafwiri, MM, Mathenge, W, McCormick, I, Morjaria, P, Mowatt, L, Muirhead, D, Murthy, GVS, Mwangi, N, Patel, DB, Peto, T, Qureshi, BM, Salomao, SR, Sarah, V, Shilio, BR, Solomon, AW, Swenor, BK, Taylor, HR, Wang, N, Webson, A, West, SK, Wong, TY, Wormald, R, Yasmin, S, Yusufu, M, Silva, JC, Resnikoff, S, Ravilla, T, Gilbert, CE, Foster, A, and Faal, HB
Published: 2021

7. Prevalence of glaucoma in Thailand: a population based survey in Rom Klao District, Bangkok

Author: Bourne, RRA, Sukudom, P, Foster, PJ, Tantisevi, V, Jitapunkul, S, Lee, PS, Johnson, GJ, and Rojanapongpun, P
Subjects: Statistics, Research, Glaucoma -- Research -- Statistics
Abstract: Aim: To determine prevalence, demography, mechanism, and visual morbidity of glaucoma in urban Thai people. Methods: 790 subjects aged 50 years or older from Rom Klao district, Bangkok, Thailand, were [...]
Published: 2003

8. Global Prevalence of Blindness and Distance and Near Vision Impairment in 2020: progress towards the Vision 2020 targets and what the future holds

Author: Bourne, RRA, Adelson, J, Flaxman, S, Briant, P, Bottone, M, Vos, T, Naidoo, K, Braithwaite, T, Cicinelli, M, Jonas, J, Limburg, H, Resnikoff, S, Silvester, A, Nangia, V, Taylor, HR, Bourne, RRA, Adelson, J, Flaxman, S, Briant, P, Bottone, M, Vos, T, Naidoo, K, Braithwaite, T, Cicinelli, M, Jonas, J, Limburg, H, Resnikoff, S, Silvester, A, Nangia, V, and Taylor, HR
Published: 2020

9. Prevalence and causes of vision loss in East Asia in 2015: magnitude, temporal trends and projections

Author: Cheng, C-Y, Wang, N, Wong, TY, Congdon, N, He, M, Wang, YX, Braithwaite, T, Casson, RJ, Cicinelli, MV, Das, A, Flaxman, SR, Jonas, JB, Keeffe, JE, Kempen, JH, Leasher, J, Limburg, H, Naidoo, K, Pesudovs, K, Resnikoff, S, Silvester, AJ, Tahhan, N, Taylor, HR, Bourne, RRA, Cheng, C-Y, Wang, N, Wong, TY, Congdon, N, He, M, Wang, YX, Braithwaite, T, Casson, RJ, Cicinelli, MV, Das, A, Flaxman, SR, Jonas, JB, Keeffe, JE, Kempen, JH, Leasher, J, Limburg, H, Naidoo, K, Pesudovs, K, Resnikoff, S, Silvester, AJ, Tahhan, N, Taylor, HR, and Bourne, RRA
Abstract: BACKGROUND: To determine the prevalence and causes of blindness and vision impairment (VI) in East Asia in 2015 and to forecast the trend to 2020. METHODS: Through a systematic literature review and meta-analysis, we estimated prevalence of blindness (presenting visual acuity <3/60 in the better eye), moderate-to-severe vision impairment (MSVI; 3/60≤presenting visual acuity <6/18), mild vision impairment (mild VI: 6/18≤presenting visual acuity <6/12) and uncorrected presbyopia for 1990, 2010, 2015 and 2020. A total of 44 population-based studies were included. RESULTS: In 2015, age-standardised prevalence of blindness, MSVI, mild VI and uncorrected presbyopia was 0.37% (80% uncertainty interval (UI) 0.12%-0.68%), 3.06% (80% UI 1.35%-5.16%) and 2.65% (80% UI 0.92%-4.91%), 32.91% (80% UI 18.72%-48.47%), respectively, in East Asia. Cataract was the leading cause of blindness (43.6%), followed by uncorrected refractive error (12.9%), glaucoma, age-related macular degeneration, corneal diseases, trachoma and diabetic retinopathy (DR). The leading cause for MSVI was uncorrected refractive error, followed by cataract, age-related macular degeneration, glaucoma, corneal disease, trachoma and DR. The burden of VI due to uncorrected refractive error, cataracts, glaucoma and DR has continued to rise over the decades reported. CONCLUSIONS: Addressing the public healthcare barriers for cataract and uncorrected refractive error can help eliminate almost 57% of all blindness cases in this region. Therefore, public healthcare efforts should be focused on effective screening and effective patient education, with access to high-quality healthcare.
Published: 2020

10. Estimating the global cost of vision impairment and its major causes: protocol for a systematic review

Author: Marques, AP, Ramke, J, Cairns, J, Butt, T, Zhang, JH, Faal, HB, Taylor, H, Jones, I, Congdon, N, Bastawrous, A, Braithwaite, T, Jovic, M, Resnikoff, S, Nandakumar, A, Khaw, PT, Bourne, RRA, Gordon, I, Frick, K, Burton, MJ, Marques, AP, Ramke, J, Cairns, J, Butt, T, Zhang, JH, Faal, HB, Taylor, H, Jones, I, Congdon, N, Bastawrous, A, Braithwaite, T, Jovic, M, Resnikoff, S, Nandakumar, A, Khaw, PT, Bourne, RRA, Gordon, I, Frick, K, and Burton, MJ
Abstract: Introduction Vision impairment (VI) places a burden on individuals, health systems and society in general. In order to support the case for investing in eye health services, an updated cost of illness study that measures the global impact of VI is necessary. To perform such a study, a systematic review of the literature is needed. Here we outline the protocol for a systematic review to describe and summarise the costs associated with VI and its major causes. Methods and analysis We will systematically search in Medline (Ovid) and the Centre for Reviews and Dissemination database which includes the National Health Service Economics Evaluation Database. No language or geographical restriction will be applied. Additional literature will be identified by reviewing the references in the included studies and by contacting field experts. Grey literature will be considered. The review will include any study published from 1 January 2000 to November 2019 that provides information about costs of illness, burden of disease and/or loss of well-being in participants with VI due to an unspecified cause or due to one of the seven leading causes globally. Two reviewers will independently screen studies and extract relevant data from included studies. Methodological quality of economic studies will be assessed based on the British Medical Journal checklist for economic submissions adapted to costs of illness studies. This protocol has been prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols and has been published prospectively in Open Science Framework. Ethics and dissemination Formal ethical approval is not required, as primary data will not be collected in this review. The findings of this study will be disseminated through peer-reviewed publications, stakeholder meetings and inclusion in the ongoing Lancet Global Health Commission on Global Eye Health.
Published: 2020

11. Health system dynamics analysis of eyecare services in Trinidad and Tobago and progress towards Vision 2020 Goals

Author: Tasanee Braithwaite, Debra Bartholomew, Bourne Rra., Henry Bailey, Subash Sharma, R Sharma, B Winford, Samuel Ramsewak, Petra Bridgemohan, Juan Carlos Silva, Deo Singh, and Alastair Gray
Subjects: Adult, Male, Optometrists, medicine.medical_specialty, Systems Analysis, Eye Diseases, Population, Blindness, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Outpatients, medicine, Health insurance, Humans, 030212 general & internal medicine, education, Aged, Aged, 80 and over, education.field_of_study, Government, Ophthalmologists, business.industry, Health Policy, Public health, Public sector, Stakeholder, Middle Aged, Private sector, System dynamics, Ophthalmology, Trinidad and Tobago, Family medicine, Workforce, 030221 ophthalmology & optometry, Optometry, Female, Health Expenditures, business
Abstract: Avoidable blindness is an important global public health concern. This study aimed to assess Trinidad and Tobago's progress towards achieving the Pan American Health Organization, 'Strategic Framework for Vision 2020: The Right to Sight-Caribbean Region,' indicators through comprehensive review of the eyecare system, in order to facilitate health system priority setting. We administered structured surveys to six stakeholder groups, including eyecare providers, patients and older adult participants in the National Eye Survey of Trinidad and Tobago. We reviewed reports, registers and policy documents, and used a health system dynamics framework to synthesize data. In 2014, the population of 1.3 million were served by a pluralistic eyecare system, which had achieved 14 out of 27 Strategic Framework indicators. The Government provided free primary, secondary and emergency eyecare services, through 108 health centres and 5 hospitals (0.26 ophthalmologists and 1.32 ophthalmologists-in-training per 50 000 population). Private sector optometrists (4.37 per 50 000 population), and ophthalmologists (0.93 per 50 000 population) provided 80% of all eyecare. Only 19.3% of the adult population had private health insurance, revealing significant out-of-pocket expenditure. We identified potential weaknesses in the eyecare system where investment might reduce avoidable blindness. These included a need for more ophthalmic equipment and maintenance in the public sector, national screening programmes for diabetic retinopathy, retinopathy of prematurity and neonatal eye defects, and pathways to ensure timely and equitable access to subspecialized surgery. Eyecare for older adults was responsible for an estimated 9.5% (US$22.6 million) of annual health expenditure. This study used the health system dynamics framework and new data to identify priorities for eyecare system strengthening. We recommend this approach for exploring potential health system barriers to addressing avoidable blindness, and other important public health problems.
Published: 2017

12. Prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe in 2015: magnitude, temporal trends and projections

Author: Bourne, RRA, Jonas, JB, Bron, AM, Cicinelli, MV, Das, A, Flaxman, SR, Friedman, DS, Keeffe, JE, Kempen, JH, Leasher, J, Limburg, H, Naidoo, K, Pesudovs, K, Peto, T, Saadine, J, Silvester, AJ, Tahhan, N, Taylor, HR, Varma, R, Wong, TY, Resnikoff, S, Bourne, RRA, Jonas, JB, Bron, AM, Cicinelli, MV, Das, A, Flaxman, SR, Friedman, DS, Keeffe, JE, Kempen, JH, Leasher, J, Limburg, H, Naidoo, K, Pesudovs, K, Peto, T, Saadine, J, Silvester, AJ, Tahhan, N, Taylor, HR, Varma, R, Wong, TY, and Resnikoff, S
Abstract: BACKGROUND: Within a surveillance of the prevalence and causes of vision impairment in high-income regions and Central/Eastern Europe, we update figures through 2015 and forecast expected values in 2020. METHODS: Based on a systematic review of medical literature, prevalence of blindness, moderate and severe vision impairment (MSVI), mild vision impairment and presbyopia was estimated for 1990, 2010, 2015, and 2020. RESULTS: Age-standardised prevalence of blindness and MSVI for all ages decreased from 1990 to 2015 from 0.26% (0.10-0.46) to 0.15% (0.06-0.26) and from 1.74% (0.76-2.94) to 1.27% (0.55-2.17), respectively. In 2015, the number of individuals affected by blindness, MSVI and mild vision impairment ranged from 70 000, 630 000 and 610 000, respectively, in Australasia to 980 000, 7.46 million and 7.25 million, respectively, in North America and 1.16 million, 9.61 million and 9.47 million, respectively, in Western Europe. In 2015, cataract was the most common cause for blindness, followed by age-related macular degeneration (AMD), glaucoma, uncorrected refractive error, diabetic retinopathy and cornea-related disorders, with declining burden from cataract and AMD over time. Uncorrected refractive error was the leading cause of MSVI. CONCLUSIONS: While continuing to advance control of cataract and AMD as the leading causes of blindness remains a high priority, overcoming barriers to uptake of refractive error services would address approximately half of the MSVI burden. New data on burden of presbyopia identify this entity as an important public health problem in this population. Additional research on better treatments, better implementation with existing tools and ongoing surveillance of the problem is needed.
Published: 2018

13. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis

Author: Bourne, RRA, Flaxman, SR, Braithwaite, T, Cicinelli, MV, Das, A, Jonas, JB, Keeffe, J, Kempen, JH, Leasher, J, Limburg, H, Naidoo, K ; https://orcid.org/0000-0001-8261-9779, Pesudovs, K ; https://orcid.org/0000-0002-6322-9369, Resnikoff, S ; https://orcid.org/0000-0002-5866-4446, Silvester, A, Stevens, GA, Tahhan, N, Wong, TY, Taylor, HR, Ackland, P, Arditi, A, Barkana, Y, Bozkurt, B, Wormald, R, Bron, A, Budenz, D, Cai, F, Casson, R, Chakravarthy, U, Congdon, N, Peto, T, Choi, J, Dana, R, Palaiou, M, Dandona, R, Dandona, L, Shen, T, Dekaris, I, Del Monte, M, Deva, J, Dreer, L, Frazier, M, Ellwein, L, Hejtmancik, J, Frick, K, Friedman, D, Javitt, J, Munoz, B, Quigley, H, Ramulu, P, Robin, A, Tielsch, J, West, S, Furtado, J, Gao, H, Gazzard, G, George, R, Gichuhi, S, Gonzalez, V, Hammond, B, Hartnett, ME, He, M, Hirai, F, Huang, J, Ingram, A, Joslin, C, Khanna, R ; https://orcid.org/0000-0002-8698-5562, Stambolian, D, Khairallah, M, Kim, J, Lambrou, G, Lansingh, VC, Lanzetta, P, Lim, J, Mansouri, K, Mathew, A, Morse, A, Musch, D, Nangia, V, Battaglia, M, Yaacov, F, Raju, M, Rossetti, L, Saaddine, J, Sandar, M, Serle, J, Shetty, R, Sieving, P, Silva, JC, Sitorus, RS, Tejedor, J, Tsilimbaris, M, van Meurs, J, Varma, R, Virgili, G, Volmink, J, Xing, Y, Wang, NL, Wiedemann, P, Zheng, Y, Keeffe, Jill, Bourne, RRA, Flaxman, SR, Braithwaite, T, Cicinelli, MV, Das, A, Jonas, JB, Keeffe, J, Kempen, JH, Leasher, J, Limburg, H, Naidoo, K ; https://orcid.org/0000-0001-8261-9779, Pesudovs, K ; https://orcid.org/0000-0002-6322-9369, Resnikoff, S ; https://orcid.org/0000-0002-5866-4446, Silvester, A, Stevens, GA, Tahhan, N, Wong, TY, Taylor, HR, Ackland, P, Arditi, A, Barkana, Y, Bozkurt, B, Wormald, R, Bron, A, Budenz, D, Cai, F, Casson, R, Chakravarthy, U, Congdon, N, Peto, T, Choi, J, Dana, R, Palaiou, M, Dandona, R, Dandona, L, Shen, T, Dekaris, I, Del Monte, M, Deva, J, Dreer, L, Frazier, M, Ellwein, L, Hejtmancik, J, Frick, K, Friedman, D, Javitt, J, Munoz, B, Quigley, H, Ramulu, P, Robin, A, Tielsch, J, West, S, Furtado, J, Gao, H, Gazzard, G, George, R, Gichuhi, S, Gonzalez, V, Hammond, B, Hartnett, ME, He, M, Hirai, F, Huang, J, Ingram, A, Joslin, C, Khanna, R ; https://orcid.org/0000-0002-8698-5562, Stambolian, D, Khairallah, M, Kim, J, Lambrou, G, Lansingh, VC, Lanzetta, P, Lim, J, Mansouri, K, Mathew, A, Morse, A, Musch, D, Nangia, V, Battaglia, M, Yaacov, F, Raju, M, Rossetti, L, Saaddine, J, Sandar, M, Serle, J, Shetty, R, Sieving, P, Silva, JC, Sitorus, RS, Tejedor, J, Tsilimbaris, M, van Meurs, J, Varma, R, Virgili, G, Volmink, J, Xing, Y, Wang, NL, Wiedemann, P, Zheng, Y, and Keeffe, Jill
Abstract: Background Global and regional prevalence estimates for blindness and vision impairment are important for the development of public health policies. We aimed to provide global estimates, trends, and projections of global blindness and vision impairment. Methods We did a systematic review and meta-analysis of population-based datasets relevant to global vision impairment and blindness that were published between 1980 and 2015. We fitted hierarchical models to estimate the prevalence (by age, country, and sex), in 2015, of mild visual impairment (presenting visual acuity worse than 6/12 to 6/18 inclusive), moderate to severe visual impairment (presenting visual acuity worse than 6/18 to 3/60 inclusive), blindness (presenting visual acuity worse than 3/60), and functional presbyopia (defined as presenting near vision worse than N6 or N8 at 40 cm when best-corrected distance visual acuity was better than 6/12). Findings Globally, of the 7·33 billion people alive in 2015, an estimated 36·0 million (80% uncertainty interval [UI] 12·9–65·4) were blind (crude prevalence 0·48%; 80% UI 0·17–0·87; 56% female), 216·6 million (80% UI 98·5–359·1) people had moderate to severe visual impairment (2·95%, 80% UI 1·34–4·89; 55% female), and 188·5 million (80% UI 64·5–350·2) had mild visual impairment (2·57%, 80% UI 0·88–4·77; 54% female). Functional presbyopia affected an estimated 1094·7 million (80% UI 581·1–1686·5) people aged 35 years and older, with 666·7 million (80% UI 364·9–997·6) being aged 50 years or older. The estimated number of blind people increased by 17·6%, from 30·6 million (80% UI 9·9–57·3) in 1990 to 36·0 million (80% UI 12·9–65·4) in 2015. This change was attributable to three factors, namely an increase because of population growth (38·4%), population ageing after accounting for population growth (34·6%), and reduction in age-specific prevalence (−36·7%). The number of people with moderate and severe visual impairment also increased, from 159·9 million (80% UI 68
Published: 2017

14. Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis

Author: Flaxman, SR, Bourne, RRA, Resnikoff, S ; https://orcid.org/0000-0002-5866-4446, Ackland, P, Braithwaite, T, Cicinelli, MV, Das, A, Jonas, JB, Keeffe, J, Kempen, JH, Leasher, J, Limburg, H, Naidoo, K ; https://orcid.org/0000-0001-8261-9779, Pesudovs, K ; https://orcid.org/0000-0002-6322-9369, Silvester, A, Stevens, GA, Tahhan, N, Wong, TY, Taylor, HR, Arditi, A, Barkana, Y, Bozkurt, B, Bron, A, Budenz, D, Cai, F, Casson, R, Chakravarthy, U, Choi, J, Congdon, N, Dana, R, Dandona, R, Dandona, L, Dekaris, I, Del Monte, M, Deva, J, Dreer, L, Ellwein, L, Frazier, M, Frick, K, Friedman, D, Furtado, J, Gao, H, Gazzard, G, George, R, Gichuhi, S, Gonzalez, V, Hammond, B, Hartnett, ME, He, M, Hejtmancik, J, Hirai, F, Huang, J, Ingram, A, Javitt, J, Joslin, C, Khairallah, M, Khanna, R ; https://orcid.org/0000-0002-8698-5562, Kim, J, Lambrou, G, Lansingh, VC, Lanzetta, P, Lim, J, Mansouri, K, Mathew, A, Morse, A, Munoz, B, Musch, D, Nangia, V, Palaiou, M, Parodi, MB, Pena, FY, Peto, T, Quigley, H, Raju, M, Ramulu, P, Reza, D, Robin, A, Rossetti, L, Saaddine, J, Sandar, M, Serle, J, Shen, T, Shetty, R, Sieving, P, Silva, JC, Sitorus, RS, Stambolian, D, Tejedor, J, Tielsch, J, Tsilimbaris, M, van Meurs, J, Varma, R, Virgili, G, Wang, YX, Wang, NL, West, S, Wiedemann, P, Wormald, R, Zheng, Y, Keeffe, Jill, Flaxman, SR, Bourne, RRA, Resnikoff, S ; https://orcid.org/0000-0002-5866-4446, Ackland, P, Braithwaite, T, Cicinelli, MV, Das, A, Jonas, JB, Keeffe, J, Kempen, JH, Leasher, J, Limburg, H, Naidoo, K ; https://orcid.org/0000-0001-8261-9779, Pesudovs, K ; https://orcid.org/0000-0002-6322-9369, Silvester, A, Stevens, GA, Tahhan, N, Wong, TY, Taylor, HR, Arditi, A, Barkana, Y, Bozkurt, B, Bron, A, Budenz, D, Cai, F, Casson, R, Chakravarthy, U, Choi, J, Congdon, N, Dana, R, Dandona, R, Dandona, L, Dekaris, I, Del Monte, M, Deva, J, Dreer, L, Ellwein, L, Frazier, M, Frick, K, Friedman, D, Furtado, J, Gao, H, Gazzard, G, George, R, Gichuhi, S, Gonzalez, V, Hammond, B, Hartnett, ME, He, M, Hejtmancik, J, Hirai, F, Huang, J, Ingram, A, Javitt, J, Joslin, C, Khairallah, M, Khanna, R ; https://orcid.org/0000-0002-8698-5562, Kim, J, Lambrou, G, Lansingh, VC, Lanzetta, P, Lim, J, Mansouri, K, Mathew, A, Morse, A, Munoz, B, Musch, D, Nangia, V, Palaiou, M, Parodi, MB, Pena, FY, Peto, T, Quigley, H, Raju, M, Ramulu, P, Reza, D, Robin, A, Rossetti, L, Saaddine, J, Sandar, M, Serle, J, Shen, T, Shetty, R, Sieving, P, Silva, JC, Sitorus, RS, Stambolian, D, Tejedor, J, Tielsch, J, Tsilimbaris, M, van Meurs, J, Varma, R, Virgili, G, Wang, YX, Wang, NL, West, S, Wiedemann, P, Wormald, R, Zheng, Y, and Keeffe, Jill
Abstract: Background Contemporary data for causes of vision impairment and blindness form an important basis of recommendations in public health policies. Refreshment of the Global Vision Database with recently published data sources permitted modelling of cause of vision loss data from 1990 to 2015, further disaggregation by cause, and forecasts to 2020. Methods In this systematic review and meta-analysis, we analysed published and unpublished population-based data for the causes of vision impairment and blindness from 1980 to 2014. We identified population-based studies published before July 8, 2014, by searching online databases with no language restrictions (MEDLINE from Jan 1, 1946, and Embase from Jan 1, 1974, and the WHO Library Database). We fitted a series of regression models to estimate the proportion of moderate or severe vision impairment (defined as presenting visual acuity of <6/18 but ≥3/60 in the better eye) and blindness (presenting visual acuity of <3/60 in the better eye) by cause, age, region, and year. Findings We identified 288 studies of 3 983 541 participants contributing data from 98 countries. Among the global population with moderate or severe vision impairment in 2015 (216·6 million [80% uncertainty interval 98·5 million to 359·1 million]), the leading causes were uncorrected refractive error (116·3 million [49·4 million to 202·1 million]), cataract (52·6 million [18·2 million to 109·6 million]), age-related macular degeneration (8·4 million [0·9 million to 29·5 million]), glaucoma (4·0 million [0·6 million to 13·3 million]), and diabetic retinopathy (2·6 million [0·2 million to 9·9 million]). Among the global population who were blind in 2015 (36·0 million [12·9 million to 65·4 million]), the leading causes were cataract (12·6 million [3·4 million to 28·7 million]), uncorrected refractive error (7·4 million [2·4 million to 14·8 million]), and glaucoma (2·9 million [0·4 million to 9·9 million]). By 2020, among the global population with moderate o
Published: 2017

15. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016

Author: Wang, H, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abera, SF, Abraha, HN, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adedoyin, RA, Adetifa, IMO, Adetokunboh, O, Afshin, A, Aggarwal, R, Agrawal, A, Agrawal, S, Kiadaliri, AA, Ahmed, MB, Aichour, AN, Aichour, I, Aichour, MTE, Aiyar, S, Akanda, S, Akinyemiju, TF, Akseer, N, Al-Eyadhy, A, Al Lami, FH, Alabed, S, Alahdab, F, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Aldridge, RW, Alene, KA, Alhabib, S, Ali, R, Alizadeh-Navaei, R, Aljunid, SM, Alkaabi, JM, Alkerwi, A, Alla, F, Allam, SD, Allebeck, P, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Ameh, EA, Amini, E, Ammar, W, Amoako, YA, Anber, N, Andrei, CL, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Anwari, P, Arnlov, J, Arora, M, Al, A, Aryal, KK, Asayesh, H, Asgedom, SW, Asghar, RJ, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Babalola, TK, Bacha, U, Badawi, A, Balakrishnan, K, Balalla, S, Barac, A, Barber, RM, Barboza, MA, Barker-Collo, SL, Barnighausen, T, Barquera, S, Barregard, L, Barrero, LH, Baune, BT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Bejot, Y, Bekele, BB, Bell, ML, Bello, AK, Bennett, DA, Bennett, JR, Bensenor, IM, Benson, J, Berhane, A, Berhe, DF, Bernabe, E, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhaumik, S ; https://orcid.org/0000-0001-9579-4453, Bhutta, ZA, Bikbov, B, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bjerregaard, P, Blosser, CD, Boneya, DJ, Boufous, S ; https://orcid.org/0000-0002-5686-1729, Bourne, RRA, Brazinova, A, Breitborde, NJK, Brenner, H, Brugha, TS, Bukhman, G, Negesa, L, Bulto, B, Bumgarner, BR, Burch, M, Butt, ZA, Cahill, LE, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Car, M, Crdenas, R, Carpenter, DO, Carrero, JJ, Carter, A, Castaneda-Orjuela, CA, Rivas, JC, Castro, FF, Castro, RE, Catala-Lopez, F, Chen, H, Chiang, PP-C, Chibalabala, M, Chisumpa, VH, Chitheer, AA, Choi, J-YJ, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Cohen, AJ, Colquhoun, SM, Coresh, J, Criqui, MH, Cromwell, EA, Crump, JA, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, de Courten, B, De Leo, D, Degenhardt, L ; https://orcid.org/0000-0002-8513-2218, Deiparine, S, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dherani, MK, Diaz-Torne, C, Ding, EL, Dixit, P, Djalalinia, S, Huyen, PD, Doku, DT, Donnelly, CA, Priscila, K, dos Santos, B, Douwes-Schultz, D, Driscoll, TR, Duan, L, Dubey, M, Duncan, BB, Dwivedi, LK, Ebrahimi, H, El Bcheraoui, C, Ellingsen, CL, Enayati, A, Endries, AY, Ermakov, SP, Eshetie, S, Eshrati, B, Eskandarieh, S, Esteghamati, A, Estep, K, Fanuel, BBF, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Filip, I, Fischer, F, Foigt, N, Foreman, KJ, Frank, T, Franklin, RC, Fraser, M, Friedman, J, Frostad, JJ, Fullman, N, Furst, T, Furtado, JM, Futran, ND, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gankpe, FG, Garcia-Basteiro, AL, Gebregergs, GB, Gebrehiwot, TT, Gebrekidan, KG, Gebremichael, MW, Gelaye, AA, Geleijnse, JM, Gemechu, BL, Gemechu, KS, Genova-Maleras, R, Gesesew, HA, Gething, PW, Gibney, KB, Gill, PS, Gillum, RF, Giref, AZ, Girma, BW, Giussani, G, Goenka, S, Gomez, B, Gona, PN, Gopalani, SV, Goulart, AC, Graetz, N, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Haagsma, JA, Hafezi-Nejad, N, Bidgoli, HH, Hakuzimana, A, Halasa, YA, Hamadeh, RR, Hambisa, MT ; https://orcid.org/0000-0003-3193-8053, Hamidi, S, Hammami, M, Hancock, J, Handal, AJ, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Harikrishnan, S, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, He, F, Heredia-Pi, IB, Herteliu, C, Hilawe, EH, Hoek, HW, Horita, N, Hosgood, HD, Hostiuc, S, Hotez, PJ, Hoy, DG, Hsairi, M, Htet, AS, Hu, G, Huang, H, Huang, JJ, Iburg, KM, Igumbor, EU, Ileanu, BV, Inoue, M, Irenso, AA, Irvine, CMS, Islam, N, Jacobsen, KH, Jaenisch, T, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jeemon, P, Jensen, PN, Jha, V ; https://orcid.org/0000-0002-8015-9470, Jin, Y, John, D, John, O ; https://orcid.org/0000-0002-9008-1726, Johnson, SC, Jonas, JB, Jurisson, M, Kabir, Z, Kadel, R, Kahsay, A, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Karthikeyan, G, Kasaeian, A, Kassaw, NA, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kaul, A, Kawakami, N, Kazanjan, K, Keiyoro, PN, Kelbore, SG, Kemp, AH, Kengne, AP, Keren, A, Kereselidze, M, Kesavachandran, CN, Ketema, EB, Khader, YS, Khalil, IA, Khan, EA, Khan, G, Khang, Y-H, Khera, S, Khoja, ATA, Khosravi, MH, Kibret, GD, Kieling, C, Kim, C-I, Kim, D, Kim, P, Kim, S, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kishawi, S, Kissimova-Skarbek, KA, Kissoon, N, Kivimaki, M, Knudsen, AK, Kokubo, Y, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulikoff, XR, Kulkarni, VS, Kumar, GA, Kumar, P, Kumsa, FA, Kutz, M, Lachat, C, Lagat, AK, Lager, ACJ, Lal, DK, Lalloo, R, Lambert, N, Lan, Q, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Lavados, PM, Laxmaiah, A, Lee, PH, Leigh, J, Leung, J ; https://orcid.org/0000-0001-5816-2959, Leung, R, Levi, M, Li, Y, Liao, Y, Liben, ML, Lim, SS, Linn, S, Lipshultz, SE, Liu, S, Lodha, R, Logroscino, G, Lorch, SA, Lorkowski, S, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Ma, S, Macarayan, ERK, Machado, IE, Mackay, MT, Abd el Razek, MM, Magis-Rodriguez, C, Mahdavi, M, Majdan, M, Majdzadeh, R, Majeed, A, Malekzadeh, R, Malhotra, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marczak, LB, Marks, GB ; https://orcid.org/0000-0002-8976-8053, Martinez-Raga, J, Martins-Melo, FR, Massano, J, Maulik, PK ; https://orcid.org/0000-0001-6835-6175, Mayosi, BM, Mazidi, M, McAlinden, C, McGarvey, ST, McGrath, JJ, Mckee, M, Mehata, S, Mehndiratta, MM, Mehta, KM, Meier, T, Mekonnen, TC, Meles, KG, Memiah, P, Memish, ZA, Mendoza, W, Mengesha, MM, Mengistie, MA, Tadese, D, Menon, MGR, Menota, BG, Mensah, GA, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Mikesell, J, Miller, TR, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Misganaw, A, Mishra, SR, Mohammad, KA, Mohammadi, A, Mohammed, KESM, Mohan, MBV, Mohanty, SK, Mokdad, AH, Assaye, AM, Mollenkopf, SK, Molokhia, M, Monasta, L, Hernandez, JCM, Montico, M, Mooney, MD, Moore, AR, Moradi-Lakeh, M, Moraga, P, Morawska, L, Velasquez, IM, Mori, R, Morrison, SD, Mruts, KB, Mueller, UO, Mullany, E, Muller, K, Venkata, G, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naidoo, KS ; https://orcid.org/0000-0001-8261-9779, Nanda, L, Nangia, V, Nascimento, BR, Natarajan, G, Negoi, I, Cuong, TN, Ningrum, DNA, Nisar, MI, Nomura, M, Vuong, MN, Norheim, OF, Norrving, B, Noubiap, JJN, Nyakarahuka, L, Obermeyer, CM, O'Donnell, MJ, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olusanya, BO, Olusanya, JO, Oren, E, Ortiz, A, Osgood-Zimmerman, A, Ota, E, Owolabi, MO, Oyekale, AS, Pa, M, Pacella, RE, Pakhale, S, Pana, A, Panda, BK, Panda-Jonas, S, Park, E-K, Parsaeian, M, Patel, T, Patten, SB, Patton, GC, Paudel, D, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pervaiz, A, Pesudovs, K ; https://orcid.org/0000-0002-6322-9369, Peterson, CB, Petri, WA, Petzold, M, Phillips, MR, Piel, FB, Pigott, DM, Pishgar, F, Plass, D, Polinder, S, Popova, S, Postma, MJ, Poulton, RG, Pourmalek, F, Prasad, N, Purwar, M, Qorbani, M, Rabiee, RHS, Radfar, A, Rafay, A, Rahimi-Movaghar, A, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rahman, SU, Rai, RK, Rajsic, S, Ram, U, Rana, SM, Ranabhat, CL, Rao, PV, Rawaf, S, Ray, SE, Rego, MAS, Rehm, J, Reiner, RC, Remuzzi, G, Renzaho, AMNN, Resnikoff, S ; https://orcid.org/0000-0002-5866-4446, Rezaei, S, Rezai, MS, Ribeiro, AL, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, A, Rubagotti, E, Ruhago, GM, Saadat, S, Sabde, YD, Sachdev, PS ; https://orcid.org/0000-0002-9595-3220, Sadat, N, Safdarian, M, Safiri, SSS, Sagar, R, Sahathevan, R, Sahebkar, A, Sahraian, MA, Salama, J, Salamati, P, Salomon, JA, Salvi, SS, Samy, AM, Sanabria, JR, Sanchez-Nino, MD, Santos, IS, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Sawhney, M, Saxena, S, Saylan, MI, Schmidt, MI, Schneider, IJC, Schutte, AE ; https://orcid.org/0000-0001-9217-4937, Schwebel, DC, Schwendicke, F, Seedat, S, Seid, AM, Sepanlou, SG, Servan-Mori, EE, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shamsipour, M, Shamsizadeh, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Shen, J, Shetty, BP, Shi, P, Shibuya, K, Shigematsu, M, Shiri, R, Shiue, I, Shrime, MG, Sigfusdottir, ID, Silberberg, DH, Silpakit, N, Silva, DAS, Silva, JP, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, PK, Singh, V, Sinha, DN, Skiadaresi, E, Sligar, A, Smith, DL, Sobaih, BHA, Sobngwi, E, Soneji, S, Soriano, JB, Sreeramareddy, CT, Srinivasan, V, Stathopoulou, V, Steel, N, Stein, DJ, Steiner, C, Stockl, H, Stokes, MA, Strong, M, Sufiyan, MB, Suliankatchi, RA, Sunguya, BF, Sur, PJ, Swaminathan, S, Sykes, BL, Szoeke, CEI, Tabares-Seisdedos, R, Tadakamadla, SK, Tadese, F, Tandon, N, Tanne, D, Tarajia, M, Tavakkoli, M, Taveira, N, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Temsah, M-H, Terkawi, AS, Tesema, CL, Tesssema, B, Theis, A, Thomas, N, Thompson, AH, Thomson, AJ, Thrift, AG, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Topouzis, F, Tortajada, M, Tran, BX, Trujillo, TTU, Tsilimparis, N, Tuem, KB, Tuzcu, EM, Tyrovolas, S, Ukwaja, KN, Undurraga, EA, Uthman, OA, Uzochukwu, BSC, van Boven, JFM, Varakin, YY, Varughese, S, Vasankari, T, Vasconcelos, AMN, Venketasubramanian, N, Vidavalur, R, Violante, FS, Vishnu, A, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Waid, JL, Wakayo, T, Wang, Y-P, Weichenthal, S, Weiderpass, E, Weintraub, RG, Werdecker, A, Wesana, J, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Workicho, A, Workie, SB, Xavier, D, Xu, G, Yaghoubi, M, Yakob, B, Yalew, AZ, Yan, LL, Yano, Y, Yaseri, M, Ye, P ; https://orcid.org/0000-0002-2924-1436, Yimam, HH, Yip, P, Yirsaw, BD, Yonemoto, N, Yoon, S-J, Yotebieng, M, Younis, MZ, Zaidi, Z, Zaki, MES, Zeeb, H, Zenebe, ZM, Zerfu, TA, Zhang, AL, Zhang, X, Zodpey, S, Zuhlke, LJ, Lopez, AD, Murray, CJL, Wang, H, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abera, SF, Abraha, HN, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adedoyin, RA, Adetifa, IMO, Adetokunboh, O, Afshin, A, Aggarwal, R, Agrawal, A, Agrawal, S, Kiadaliri, AA, Ahmed, MB, Aichour, AN, Aichour, I, Aichour, MTE, Aiyar, S, Akanda, S, Akinyemiju, TF, Akseer, N, Al-Eyadhy, A, Al Lami, FH, Alabed, S, Alahdab, F, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Aldridge, RW, Alene, KA, Alhabib, S, Ali, R, Alizadeh-Navaei, R, Aljunid, SM, Alkaabi, JM, Alkerwi, A, Alla, F, Allam, SD, Allebeck, P, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Ameh, EA, Amini, E, Ammar, W, Amoako, YA, Anber, N, Andrei, CL, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Anwari, P, Arnlov, J, Arora, M, Al, A, Aryal, KK, Asayesh, H, Asgedom, SW, Asghar, RJ, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Quintanilla, BPA, Babalola, TK, Bacha, U, Badawi, A, Balakrishnan, K, Balalla, S, Barac, A, Barber, RM, Barboza, MA, Barker-Collo, SL, Barnighausen, T, Barquera, S, Barregard, L, Barrero, LH, Baune, BT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Bejot, Y, Bekele, BB, Bell, ML, Bello, AK, Bennett, DA, Bennett, JR, Bensenor, IM, Benson, J, Berhane, A, Berhe, DF, Bernabe, E, Beuran, M, Beyene, AS, Bhala, N, Bhansali, A, Bhaumik, S ; https://orcid.org/0000-0001-9579-4453, Bhutta, ZA, Bikbov, B, Birungi, C, Biryukov, S, Bisanzio, D, Bizuayehu, HM, Bjerregaard, P, Blosser, CD, Boneya, DJ, Boufous, S ; https://orcid.org/0000-0002-5686-1729, Bourne, RRA, Brazinova, A, Breitborde, NJK, Brenner, H, Brugha, TS, Bukhman, G, Negesa, L, Bulto, B, Bumgarner, BR, Burch, M, Butt, ZA, Cahill, LE, Cahuana-Hurtado, L, Campos-Nonato, IR, Car, J, Car, M, Crdenas, R, Carpenter, DO, Carrero, JJ, Carter, A, Castaneda-Orjuela, CA, Rivas, JC, Castro, FF, Castro, RE, Catala-Lopez, F, Chen, H, Chiang, PP-C, Chibalabala, M, Chisumpa, VH, Chitheer, AA, Choi, J-YJ, Christensen, H, Christopher, DJ, Ciobanu, LG, Cirillo, M, Cohen, AJ, Colquhoun, SM, Coresh, J, Criqui, MH, Cromwell, EA, Crump, JA, Dandona, L, Dandona, R, Dargan, PI, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, de Courten, B, De Leo, D, Degenhardt, L ; https://orcid.org/0000-0002-8513-2218, Deiparine, S, Dellavalle, RP, Deribe, K, Deribew, A, Des Jarlais, DC, Dey, S, Dharmaratne, SD, Dherani, MK, Diaz-Torne, C, Ding, EL, Dixit, P, Djalalinia, S, Huyen, PD, Doku, DT, Donnelly, CA, Priscila, K, dos Santos, B, Douwes-Schultz, D, Driscoll, TR, Duan, L, Dubey, M, Duncan, BB, Dwivedi, LK, Ebrahimi, H, El Bcheraoui, C, Ellingsen, CL, Enayati, A, Endries, AY, Ermakov, SP, Eshetie, S, Eshrati, B, Eskandarieh, S, Esteghamati, A, Estep, K, Fanuel, BBF, Faro, A, Farvid, MS, Farzadfar, F, Feigin, VL, Fereshtehnejad, S-M, Fernandes, JG, Fernandes, JC, Feyissa, TR, Filip, I, Fischer, F, Foigt, N, Foreman, KJ, Frank, T, Franklin, RC, Fraser, M, Friedman, J, Frostad, JJ, Fullman, N, Furst, T, Furtado, JM, Futran, ND, Gakidou, E, Gambashidze, K, Gamkrelidze, A, Gankpe, FG, Garcia-Basteiro, AL, Gebregergs, GB, Gebrehiwot, TT, Gebrekidan, KG, Gebremichael, MW, Gelaye, AA, Geleijnse, JM, Gemechu, BL, Gemechu, KS, Genova-Maleras, R, Gesesew, HA, Gething, PW, Gibney, KB, Gill, PS, Gillum, RF, Giref, AZ, Girma, BW, Giussani, G, Goenka, S, Gomez, B, Gona, PN, Gopalani, SV, Goulart, AC, Graetz, N, Gugnani, HC, Gupta, PC, Gupta, R, Gupta, T, Gupta, V, Haagsma, JA, Hafezi-Nejad, N, Bidgoli, HH, Hakuzimana, A, Halasa, YA, Hamadeh, RR, Hambisa, MT ; https://orcid.org/0000-0003-3193-8053, Hamidi, S, Hammami, M, Hancock, J, Handal, AJ, Hankey, GJ, Hao, Y, Harb, HL, Hareri, HA, Harikrishnan, S, Haro, JM, Hassanvand, MS, Havmoeller, R, Hay, RJ, Hay, SI, He, F, Heredia-Pi, IB, Herteliu, C, Hilawe, EH, Hoek, HW, Horita, N, Hosgood, HD, Hostiuc, S, Hotez, PJ, Hoy, DG, Hsairi, M, Htet, AS, Hu, G, Huang, H, Huang, JJ, Iburg, KM, Igumbor, EU, Ileanu, BV, Inoue, M, Irenso, AA, Irvine, CMS, Islam, N, Jacobsen, KH, Jaenisch, T, Jahanmehr, N, Jakovljevic, MB, Javanbakht, M, Jayatilleke, AU, Jeemon, P, Jensen, PN, Jha, V ; https://orcid.org/0000-0002-8015-9470, Jin, Y, John, D, John, O ; https://orcid.org/0000-0002-9008-1726, Johnson, SC, Jonas, JB, Jurisson, M, Kabir, Z, Kadel, R, Kahsay, A, Kalkonde, Y, Kamal, R, Kan, H, Karch, A, Karema, CK, Karimi, SM, Karthikeyan, G, Kasaeian, A, Kassaw, NA, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kaul, A, Kawakami, N, Kazanjan, K, Keiyoro, PN, Kelbore, SG, Kemp, AH, Kengne, AP, Keren, A, Kereselidze, M, Kesavachandran, CN, Ketema, EB, Khader, YS, Khalil, IA, Khan, EA, Khan, G, Khang, Y-H, Khera, S, Khoja, ATA, Khosravi, MH, Kibret, GD, Kieling, C, Kim, C-I, Kim, D, Kim, P, Kim, S, Kim, YJ, Kimokoti, RW, Kinfu, Y, Kishawi, S, Kissimova-Skarbek, KA, Kissoon, N, Kivimaki, M, Knudsen, AK, Kokubo, Y, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krohn, KJ, Defo, BK, Bicer, BK, Kuipers, EJ, Kulikoff, XR, Kulkarni, VS, Kumar, GA, Kumar, P, Kumsa, FA, Kutz, M, Lachat, C, Lagat, AK, Lager, ACJ, Lal, DK, Lalloo, R, Lambert, N, Lan, Q, Lansingh, VC, Larson, HJ, Larsson, A, Laryea, DO, Lavados, PM, Laxmaiah, A, Lee, PH, Leigh, J, Leung, J ; https://orcid.org/0000-0001-5816-2959, Leung, R, Levi, M, Li, Y, Liao, Y, Liben, ML, Lim, SS, Linn, S, Lipshultz, SE, Liu, S, Lodha, R, Logroscino, G, Lorch, SA, Lorkowski, S, Lotufo, PA, Lozano, R, Lunevicius, R, Lyons, RA, Ma, S, Macarayan, ERK, Machado, IE, Mackay, MT, Abd el Razek, MM, Magis-Rodriguez, C, Mahdavi, M, Majdan, M, Majdzadeh, R, Majeed, A, Malekzadeh, R, Malhotra, R, Malta, DC, Mantovani, LG, Manyazewal, T, Mapoma, CC, Marczak, LB, Marks, GB ; https://orcid.org/0000-0002-8976-8053, Martinez-Raga, J, Martins-Melo, FR, Massano, J, Maulik, PK ; https://orcid.org/0000-0001-6835-6175, Mayosi, BM, Mazidi, M, McAlinden, C, McGarvey, ST, McGrath, JJ, Mckee, M, Mehata, S, Mehndiratta, MM, Mehta, KM, Meier, T, Mekonnen, TC, Meles, KG, Memiah, P, Memish, ZA, Mendoza, W, Mengesha, MM, Mengistie, MA, Tadese, D, Menon, MGR, Menota, BG, Mensah, GA, Meretoja, A, Meretoja, TJ, Mezgebe, HB, Micha, R, Mikesell, J, Miller, TR, Mills, EJ, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Misganaw, A, Mishra, SR, Mohammad, KA, Mohammadi, A, Mohammed, KESM, Mohan, MBV, Mohanty, SK, Mokdad, AH, Assaye, AM, Mollenkopf, SK, Molokhia, M, Monasta, L, Hernandez, JCM, Montico, M, Mooney, MD, Moore, AR, Moradi-Lakeh, M, Moraga, P, Morawska, L, Velasquez, IM, Mori, R, Morrison, SD, Mruts, KB, Mueller, UO, Mullany, E, Muller, K, Venkata, G, Murthy, S, Musa, KI, Nachega, JB, Nagata, C, Nagel, G, Naghavi, M, Naidoo, KS ; https://orcid.org/0000-0001-8261-9779, Nanda, L, Nangia, V, Nascimento, BR, Natarajan, G, Negoi, I, Cuong, TN, Ningrum, DNA, Nisar, MI, Nomura, M, Vuong, MN, Norheim, OF, Norrving, B, Noubiap, JJN, Nyakarahuka, L, Obermeyer, CM, O'Donnell, MJ, Ogbo, FA, Oh, I-H, Okoro, A, Oladimeji, O, Olagunju, AT, Olusanya, BO, Olusanya, JO, Oren, E, Ortiz, A, Osgood-Zimmerman, A, Ota, E, Owolabi, MO, Oyekale, AS, Pa, M, Pacella, RE, Pakhale, S, Pana, A, Panda, BK, Panda-Jonas, S, Park, E-K, Parsaeian, M, Patel, T, Patten, SB, Patton, GC, Paudel, D, Pereira, DM, Perez-Padilla, R, Perez-Ruiz, F, Perico, N, Pervaiz, A, Pesudovs, K ; https://orcid.org/0000-0002-6322-9369, Peterson, CB, Petri, WA, Petzold, M, Phillips, MR, Piel, FB, Pigott, DM, Pishgar, F, Plass, D, Polinder, S, Popova, S, Postma, MJ, Poulton, RG, Pourmalek, F, Prasad, N, Purwar, M, Qorbani, M, Rabiee, RHS, Radfar, A, Rafay, A, Rahimi-Movaghar, A, Rahimi-Movaghar, V, Rahman, M, Rahman, MHU, Rahman, SU, Rai, RK, Rajsic, S, Ram, U, Rana, SM, Ranabhat, CL, Rao, PV, Rawaf, S, Ray, SE, Rego, MAS, Rehm, J, Reiner, RC, Remuzzi, G, Renzaho, AMNN, Resnikoff, S ; https://orcid.org/0000-0002-5866-4446, Rezaei, S, Rezai, MS, Ribeiro, AL, Rokni, MB, Ronfani, L, Roshandel, G, Roth, GA, Rothenbacher, D, Roy, A, Rubagotti, E, Ruhago, GM, Saadat, S, Sabde, YD, Sachdev, PS ; https://orcid.org/0000-0002-9595-3220, Sadat, N, Safdarian, M, Safiri, SSS, Sagar, R, Sahathevan, R, Sahebkar, A, Sahraian, MA, Salama, J, Salamati, P, Salomon, JA, Salvi, SS, Samy, AM, Sanabria, JR, Sanchez-Nino, MD, Santos, IS, Milicevic, MMS, Sarmiento-Suarez, R, Sartorius, B, Satpathy, M, Sawhney, M, Saxena, S, Saylan, MI, Schmidt, MI, Schneider, IJC, Schutte, AE ; https://orcid.org/0000-0001-9217-4937, Schwebel, DC, Schwendicke, F, Seedat, S, Seid, AM, Sepanlou, SG, Servan-Mori, EE, Shackelford, KA, Shaheen, A, Shahraz, S, Shaikh, MA, Shamsipour, M, Shamsizadeh, M, Islam, SMS, Sharma, J, Sharma, R, She, J, Shen, J, Shetty, BP, Shi, P, Shibuya, K, Shigematsu, M, Shiri, R, Shiue, I, Shrime, MG, Sigfusdottir, ID, Silberberg, DH, Silpakit, N, Silva, DAS, Silva, JP, Silveira, DGA, Sindi, S, Singh, A, Singh, JA, Singh, PK, Singh, V, Sinha, DN, Skiadaresi, E, Sligar, A, Smith, DL, Sobaih, BHA, Sobngwi, E, Soneji, S, Soriano, JB, Sreeramareddy, CT, Srinivasan, V, Stathopoulou, V, Steel, N, Stein, DJ, Steiner, C, Stockl, H, Stokes, MA, Strong, M, Sufiyan, MB, Suliankatchi, RA, Sunguya, BF, Sur, PJ, Swaminathan, S, Sykes, BL, Szoeke, CEI, Tabares-Seisdedos, R, Tadakamadla, SK, Tadese, F, Tandon, N, Tanne, D, Tarajia, M, Tavakkoli, M, Taveira, N, Tehrani-Banihashemi, A, Tekelab, T, Tekle, DY, Shifa, GT, Temsah, M-H, Terkawi, AS, Tesema, CL, Tesssema, B, Theis, A, Thomas, N, Thompson, AH, Thomson, AJ, Thrift, AG, Tiruye, TY, Tobe-Gai, R, Tonelli, M, Topor-Madry, R, Topouzis, F, Tortajada, M, Tran, BX, Trujillo, TTU, Tsilimparis, N, Tuem, KB, Tuzcu, EM, Tyrovolas, S, Ukwaja, KN, Undurraga, EA, Uthman, OA, Uzochukwu, BSC, van Boven, JFM, Varakin, YY, Varughese, S, Vasankari, T, Vasconcelos, AMN, Venketasubramanian, N, Vidavalur, R, Violante, FS, Vishnu, A, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Waid, JL, Wakayo, T, Wang, Y-P, Weichenthal, S, Weiderpass, E, Weintraub, RG, Werdecker, A, Wesana, J, Wijeratne, T, Wilkinson, JD, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Workicho, A, Workie, SB, Xavier, D, Xu, G, Yaghoubi, M, Yakob, B, Yalew, AZ, Yan, LL, Yano, Y, Yaseri, M, Ye, P ; https://orcid.org/0000-0002-2924-1436, Yimam, HH, Yip, P, Yirsaw, BD, Yonemoto, N, Yoon, S-J, Yotebieng, M, Younis, MZ, Zaidi, Z, Zaki, MES, Zeeb, H, Zenebe, ZM, Zerfu, TA, Zhang, AL, Zhang, X, Zodpey, S, Zuhlke, LJ, Lopez, AD, and Murray, CJL
Abstract: Background: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. Methods: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to
Published: 2017

16. Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author: Mokdad, AH, Forouzanfar, MH, Daoud, F, El Bcheraoui, C, Moradi-Lakeh, M, Khalil, I, Afshin, A, Tuffaha, M, Charara, R, Barber, RM, Wagner, J, Cercy, K, Kravitz, H, Coates, MM, Robinson, M, Estep, K, Steiner, C, Jaber, S, Mokdad, AA, O'Rourke, KF, Chew, A, Kim, P, El Razek, MMA, Abdalla, S, Abd-Allah, F, Abraham, JP, Abu-Raddad, LJ, Abu-Rmeileh, NME, Al-Nehmi, AA, Akanda, AS, Al Ahmadi, H, Al Khabouri, MJ, Al Lami, FH, Al Rayess, ZA, Alasfoor, D, AlBuhairan, FS, Aldhahri, SF, Alghnam, S, Alhabib, S, Al-Hamad, N, Ali, R, Ali, SD, Alkhateeb, M, AlMazroa, MA, Alomari, MA, Al-Raddadi, R, Alsharif, U, Al-Sheyab, N, Alsowaidi, S, Al-Thani, M, Altirkawi, KA, Amare, AT, Amini, H, Ammar, W, Anwari, P, Asayesh, H, Asghar, R, Assabri, AM, Assadi, R, Bacha, U, Badawi, A, Bakfalouni, T, Basulaiman, MO, Bazargan-Hejazi, S, Bedi, N, Bhakta, AR, Bhutta, ZA, Bin Abdulhak, AA, Boufous, S ; https://orcid.org/0000-0002-5686-1729, Bourne, RRA, Danawi, H, Das, J, Deribew, A, Ding, EL, Durrani, AM, Elshrek, Y, Ibrahim, ME, Eshrati, B, Esteghamati, A, Faghmous, IAD, Farzadfar, F, Feigl, AB, Fereshtehnejad, SM, Filip, I, Fischer, F, Gankpé, FG, Ginawi, I, Gishu, MD, Gupta, R, Habash, RM, Hafezi-Nejad, N, Hamadeh, RR, Hamdouni, H, Hamidi, S, Harb, HL, Hassanvand, MS, Hedayati, MT, Heydarpour, P, Hsairi, M, Husseini, A, Resnikoff, Serge ; https://orcid.org/0000-0002-5866-4446, Jha, Vivekanand ; https://orcid.org/0000-0002-8015-9470, Mokdad, AH, Forouzanfar, MH, Daoud, F, El Bcheraoui, C, Moradi-Lakeh, M, Khalil, I, Afshin, A, Tuffaha, M, Charara, R, Barber, RM, Wagner, J, Cercy, K, Kravitz, H, Coates, MM, Robinson, M, Estep, K, Steiner, C, Jaber, S, Mokdad, AA, O'Rourke, KF, Chew, A, Kim, P, El Razek, MMA, Abdalla, S, Abd-Allah, F, Abraham, JP, Abu-Raddad, LJ, Abu-Rmeileh, NME, Al-Nehmi, AA, Akanda, AS, Al Ahmadi, H, Al Khabouri, MJ, Al Lami, FH, Al Rayess, ZA, Alasfoor, D, AlBuhairan, FS, Aldhahri, SF, Alghnam, S, Alhabib, S, Al-Hamad, N, Ali, R, Ali, SD, Alkhateeb, M, AlMazroa, MA, Alomari, MA, Al-Raddadi, R, Alsharif, U, Al-Sheyab, N, Alsowaidi, S, Al-Thani, M, Altirkawi, KA, Amare, AT, Amini, H, Ammar, W, Anwari, P, Asayesh, H, Asghar, R, Assabri, AM, Assadi, R, Bacha, U, Badawi, A, Bakfalouni, T, Basulaiman, MO, Bazargan-Hejazi, S, Bedi, N, Bhakta, AR, Bhutta, ZA, Bin Abdulhak, AA, Boufous, S ; https://orcid.org/0000-0002-5686-1729, Bourne, RRA, Danawi, H, Das, J, Deribew, A, Ding, EL, Durrani, AM, Elshrek, Y, Ibrahim, ME, Eshrati, B, Esteghamati, A, Faghmous, IAD, Farzadfar, F, Feigl, AB, Fereshtehnejad, SM, Filip, I, Fischer, F, Gankpé, FG, Ginawi, I, Gishu, MD, Gupta, R, Habash, RM, Hafezi-Nejad, N, Hamadeh, RR, Hamdouni, H, Hamidi, S, Harb, HL, Hassanvand, MS, Hedayati, MT, Heydarpour, P, Hsairi, M, Husseini, A, Resnikoff, Serge ; https://orcid.org/0000-0002-5866-4446, and Jha, Vivekanand ; https://orcid.org/0000-0002-8015-9470
Abstract: Background The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013. Methods GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically. Findings The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle
Published: 2016

17. Number of People Blind or Visually Impaired by Glaucoma Worldwide and in World Regions 1990-2010: A Meta-Analysis

Author: Leung, YF, Bourne, RRA, Taylor, HR, Flaxman, SR, Keeffe, J, Leasher, J, Naidoo, K, Pesudovs, K, White, RA, Wong, TY, Resnikoff, S, Jonas, JB, Leung, YF, Bourne, RRA, Taylor, HR, Flaxman, SR, Keeffe, J, Leasher, J, Naidoo, K, Pesudovs, K, White, RA, Wong, TY, Resnikoff, S, and Jonas, JB
Abstract: OBJECTIVE: To assess the number of individuals visually impaired or blind due to glaucoma and to examine regional differences and temporal changes in this parameter for the period from 1990 to 2012. METHODS: As part of the Global Burden of Diseases (GBD) Study 2010, we performed a systematic literature review for the period from 1980 to 2012. We primarily identified 14,908 relevant manuscripts, out of which 243 high-quality, population-based studies remained after review by an expert panel that involved application of selection criteria that dwelt on population representativeness and clarity of visual acuity methods used. Sixty-six specified the proportion attributable to glaucoma. The software tool DisMod-MR (Disease Modeling-Metaregression) of the GBD was used to calculate fraction of vision impairment due to glaucoma. RESULTS: In 2010, 2.1 million (95% Uncertainty Interval (UI):1.9,2.6) people were blind, and 4.2 (95% UI:3.7,5.8) million were visually impaired due to glaucoma. Glaucoma caused worldwide 6.6% (95% UI:5.9,7.9) of all blindness in 2010 and 2.2% (95% UI:2.0,2.8) of all moderate and severe visual impairment (MSVI). These figures were lower in regions with younger populations (<5% in South Asia) than in high-income regions with relatively old populations (>10%). From 1990 to 2010, the number of blind or visually impaired due to glaucoma increased by 0.8 million (95%UI:0.7, 1.1) or 62% and by 2.3 million (95%UI:2.1,3.5) or 83%, respectively. Percentage of global blindness caused by glaucoma increased between 1990 and 2010 from 4.4% (4.0,5.1) to 6.6%. Age-standardized prevalence of glaucoma related blindness and MSVI did not differ markedly between world regions nor between women. SIGNIFICANCE: By 2010, one out of 15 blind people was blind due to glaucoma, and one of 45 visually impaired people was visually impaired, highlighting the increasing global burden of glaucoma.
Published: 2016

18. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: Quantifying the epidemiological transition

Author: Murray, CJL, Barber, RM, Foreman, KJ, Ozgoren, AA, Abd-Allah, F, Abera, SF, Aboyans, V, Abraham, JP, Abubakar, I, Abu-Raddad, LJ, Abu-Rmeileh, NM, Achoki, T, Ackerman, IN, Ademi, Z, Adou, AK, Adsuar, JC, Afshin, A, Agardh, EE, Alam, SS, Alasfoor, D, Albittar, MI, Alegretti, MA, Alemu, ZA, Alfonso-Cristancho, R, Alhabib, S, Ali, R, Alla, F, Allebeck, P, Almazroa, MA, Alsharif, U, Alvarez, E, Alvis-Guzman, N, Amare, AT, Ameh, EA, Amini, H, Ammar, W, Anderson, HR, Anderson, BO, Antonio, CAT, Anwari, P, Arnlöv, J, Arsenijevic, VSA, Artaman, A, Asghar, RJ, Assadi, R, Atkins, LS, Avila, MA, Awuah, B, Bachman, VF, Badawi, A, Bahit, MC, Balakrishnan, K, Banerjee, A, Barker-Collo, SL, Barquera, S, Barregard, L, Barrero, LH, Basu, A, Basu, S, Basulaiman, MO, Beardsley, J, Bedi, N, Beghi, E, Bekele, T, Bell, ML, Benjet, C, Bennett, DA, Bensenor, IM, Benzian, H, Bernabé, E, Bertozzi-Villa, A, Beyene, TJ, Bhala, N, Bhalla, A, Bhutta, ZA, Bienhoff, K, Bikbov, B, Biryukov, S, Blore, JD, Blosser, CD, Blyth, FM, Bohensky, MA, Bolliger, IW, Başara, BB, Bornstein, NM, Bose, D, Boufous, S ; https://orcid.org/0000-0002-5686-1729, Bourne, RRA, Boyers, LN, Brainin, M, Brayne, CE, Brazinova, A, Breitborde, NJK, Brenner, H, Briggs, AD, Brooks, PM, Brown, JC, Brugha, TS, Buchbinder, R, Buckle, GC, Degenhardt, Louisa ; https://orcid.org/0000-0002-8513-2218, Resnikoff, Serge ; https://orcid.org/0000-0002-5866-4446, Mitchell, Philip ; https://orcid.org/0000-0002-7954-5235, Naidoo, Kovin ; https://orcid.org/0000-0001-8261-9779, Jha, Vivekanand ; https://orcid.org/0000-0002-8015-9470, Ye, Pengpeng ; https://orcid.org/0000-0002-2924-1436, Pesudovs, Konrad ; https://orcid.org/0000-0002-6322-9369, Murray, CJL, Barber, RM, Foreman, KJ, Ozgoren, AA, Abd-Allah, F, Abera, SF, Aboyans, V, Abraham, JP, Abubakar, I, Abu-Raddad, LJ, Abu-Rmeileh, NM, Achoki, T, Ackerman, IN, Ademi, Z, Adou, AK, Adsuar, JC, Afshin, A, Agardh, EE, Alam, SS, Alasfoor, D, Albittar, MI, Alegretti, MA, Alemu, ZA, Alfonso-Cristancho, R, Alhabib, S, Ali, R, Alla, F, Allebeck, P, Almazroa, MA, Alsharif, U, Alvarez, E, Alvis-Guzman, N, Amare, AT, Ameh, EA, Amini, H, Ammar, W, Anderson, HR, Anderson, BO, Antonio, CAT, Anwari, P, Arnlöv, J, Arsenijevic, VSA, Artaman, A, Asghar, RJ, Assadi, R, Atkins, LS, Avila, MA, Awuah, B, Bachman, VF, Badawi, A, Bahit, MC, Balakrishnan, K, Banerjee, A, Barker-Collo, SL, Barquera, S, Barregard, L, Barrero, LH, Basu, A, Basu, S, Basulaiman, MO, Beardsley, J, Bedi, N, Beghi, E, Bekele, T, Bell, ML, Benjet, C, Bennett, DA, Bensenor, IM, Benzian, H, Bernabé, E, Bertozzi-Villa, A, Beyene, TJ, Bhala, N, Bhalla, A, Bhutta, ZA, Bienhoff, K, Bikbov, B, Biryukov, S, Blore, JD, Blosser, CD, Blyth, FM, Bohensky, MA, Bolliger, IW, Başara, BB, Bornstein, NM, Bose, D, Boufous, S ; https://orcid.org/0000-0002-5686-1729, Bourne, RRA, Boyers, LN, Brainin, M, Brayne, CE, Brazinova, A, Breitborde, NJK, Brenner, H, Briggs, AD, Brooks, PM, Brown, JC, Brugha, TS, Buchbinder, R, Buckle, GC, Degenhardt, Louisa ; https://orcid.org/0000-0002-8513-2218, Resnikoff, Serge ; https://orcid.org/0000-0002-5866-4446, Mitchell, Philip ; https://orcid.org/0000-0002-7954-5235, Naidoo, Kovin ; https://orcid.org/0000-0001-8261-9779, Jha, Vivekanand ; https://orcid.org/0000-0002-8015-9470, Ye, Pengpeng ; https://orcid.org/0000-0002-2924-1436, and Pesudovs, Konrad ; https://orcid.org/0000-0002-6322-9369
Abstract: Background The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age-sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development. Methods We used the published GBD 2013 data for age-specific mortality, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) to calculate DALYs and HALE for 1990, 1995, 2000, 2005, 2010, and 2013 for 188 countries. We calculated HALE using the Sullivan method; 95% uncertainty intervals (UIs) represent uncertainty in age-specific death rates and YLDs per person for each country, age, sex, and year. We estimated DALYs for 306 causes for each country as the sum of YLLs and YLDs; 95% UIs represent uncertainty in YLL and YLD rates. We quantified patterns of the epidemiological transition with a composite indicator of sociodemographic status, which we constructed from income per person, average years of schooling after age 15 years, and the total fertility rate and mean age of the population. We applied hierarchical regression to DALY rates by cause across countries to decompose variance related to the sociodemographic status variable, country, and time. Findings Worldwide, from 1990 to 2013, life expectancy at birth rose by 6·2 years (95% UI 5·6-6·6), from 65·3 years (65·0-65·6) in 1990 to 71·5 years (71·0-71·9) in 2013, HALE at birth rose by 5·4 years (4·9-5·8), from 56·9 years (54·5-59·1) to 62·3 years (59·7-64·8), total DALYs fell by 3·6% (0·3
Published: 2015

19. Prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe in 2015: magnitude, temporal trends and projections

Author: Janet L Leasher, Tunde Peto, Jill E Keeffe, Nina Tahhan, Konrad Pesudovs, Rohit Varma, Hans Limburg, John H. Kempen, Aditi Das, Alain M. Bron, Jinan Saadine, Jost B. Jonas, Hugh R. Taylor, Rupert R A Bourne, Serge Resnikoff, David S Friedman, Tien Yin Wong, Seth Flaxman, Maria Vittoria Cicinelli, Kovin Naidoo, Alexander J Silvester, Anglia Ruskin University (ARU), University Hospital Center Mannheim, Partenaires INRAE, Centre des Sciences du Goût et de l'Alimentation [Dijon] (CSGA), Centre National de la Recherche Scientifique (CNRS)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB), Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), San Raffaele Scientific Institute, Health Education Yorkshire and the Humber, Imperial College London, Wilmer Eye Institute, Johns Hopkins University School of Medicine, L V Prasad Eye Institute, Massachusetts Eye and Ear Infirmary, Medical Center, Nova Southeastern University (NSU), Health Information Services, University of KwaZulu-Natal (UKZN), NHMRC Centre for Clinical Eye Research, Dentistry and Biomedical Sciences, Centers for Disease Control and Prevention, Royal Liverpool University Hospital, La Vision, University of New South Wales [Sydney] (UNSW), Melbourne School of Population Health, Keck School of Medicine of USC, Singapore Eye Research Institute [Singapore] (SERI), National University of Singapore (NUS), Heidelberg University, Flinders University, University of Melbourne, Bourne, Rupert R. A., Bourne, Rra, Jonas, Jb, Bron, Am, Cicinelli, Mv, Das, A, Flaxman, Sr, Friedman, D, Keeffe, Je, Kempen, Jh, Leasher, J, Limburg, H, Naidoo, K, Pesudovs, K, Peto, T, Saadine, J, Silvester, Aj, Tahhan, N, Taylor, Hr, Varma, R, Wong, Ty, Resnikoff, S, on behalf of the Vision Loss Expert Group of the Global Burden of Disease, Study, and Battaglia Parodi, M
Subjects: Refractive error, Organes des sens, genetic structures, Glaucoma, Ophthalmology & Optometry, Macular Degeneration, 0302 clinical medicine, Epidemiology, 030212 general & internal medicine, education.field_of_study, GLOBAL PREVALENCE, public health, DEGENERAÇÃO MACULAR, Diabetic retinopathy, Refractive Errors, Sensory Systems, 3. Good health, Global Issues, Blindne, Europe, 1117 Public Health And Health Services, BLINDNESS, épidémiologie, Female, INDIA, epidemiology, medicine.symptom, OPEN-ANGLE GLAUCOMA, Life Sciences & Biomedicine, Human, Developed Countrie, medicine.medical_specialty, Population, Visual impairment, Sensory Organs, Médecine humaine et pathologie, Cataract, 03 medical and health sciences, Cellular and Molecular Neuroscience, SDG 3 - Good Health and Well-being, medicine, Journal Article, Humans, VISUAL IMPAIRMENT, [SDV.MHEP.OS]Life Sciences [q-bio]/Human health and pathology/Sensory Organs, education, Diabetic Retinopathy, Science & Technology, business.industry, Developed Countries, 1103 Clinical Sciences, Presbyopia, Macular degeneration, Vision Loss Expert Group of the Global Burden of Disease Study, medicine.disease, MACULAR DEGENERATION, RANIBIZUMAB, 1113 Ophthalmology And Optometry, eye diseases, Ophthalmology, glaucoma, santé publique, glaucome, DISTANCE, 030221 ophthalmology & optometry, Human health and pathology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Demography
Abstract: BackgroundWithin a surveillance of the prevalence and causes of vision impairment in high-income regions and Central/Eastern Europe, we update figures through 2015 and forecast expected values in 2020.MethodsBased on a systematic review of medical literature, prevalence of blindness, moderate and severe vision impairment (MSVI), mild vision impairment and presbyopia was estimated for 1990, 2010, 2015, and 2020.ResultsAge-standardised prevalence of blindness and MSVI for all ages decreased from 1990 to 2015 from 0.26% (0.10–0.46) to 0.15% (0.06–0.26) and from 1.74% (0.76–2.94) to 1.27% (0.55–2.17), respectively. In 2015, the number of individuals affected by blindness, MSVI and mild vision impairment ranged from 70 000, 630 000 and 610 000, respectively, in Australasia to 980 000, 7.46 million and 7.25 million, respectively, in North America and 1.16 million, 9.61 million and 9.47 million, respectively, in Western Europe. In 2015, cataract was the most common cause for blindness, followed by age-related macular degeneration (AMD), glaucoma, uncorrected refractive error, diabetic retinopathy and cornea-related disorders, with declining burden from cataract and AMD over time. Uncorrected refractive error was the leading cause of MSVI.ConclusionsWhile continuing to advance control of cataract and AMD as the leading causes of blindness remains a high priority, overcoming barriers to uptake of refractive error services would address approximately half of the MSVI burden. New data on burden of presbyopia identify this entity as an important public health problem in this population. Additional research on better treatments, better implementation with existing tools and ongoing surveillance of the problem is needed.
Published: 2018
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20. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis

Author: Rupert R A Bourne, Seth R Flaxman, Tasanee Braithwaite, Maria V Cicinelli, Aditi Das, Jost B Jonas, Jill Keeffe, John H Kempen, Janet Leasher, Hans Limburg, Kovin Naidoo, Konrad Pesudovs, Serge Resnikoff, Alex Silvester, Gretchen A Stevens, Nina Tahhan, Tien Y Wong, Hugh R Taylor, Rupert Bourne, Peter Ackland, Aries Arditi, Yaniv Barkana, Banu Bozkurt, TASANEE BRAITHWAITE, Alain Bron, Donald Budenz, Feng Cai, Robert Casson, Usha Chakravarthy, Jaewan Choi, Maria Vittoria Cicinelli, Nathan Congdon, Reza Dana, Rakhi Dandona, Lalit Dandona, Iva Dekaris, Monte Del Monte, Jenny Deva, Laura Dreer, Leon Ellwein, Marcela Frazier, Kevin Frick, David Friedman, Joao Furtado, Hua Gao, Gus Gazzard, Ronnie George, Stephen Gichuhi, Victor Gonzalez, Billy Hammond, Mary Elizabeth Hartnett, Minguang He, James Hejtmancik, Flavio Hirai, John Huang, April Ingram, Jonathan Javitt, Jost Jonas, Charlotte Joslin, John Kempen, Moncef Khairallah, Rohit Khanna, Judy Kim, George Lambrou, Van Charles Lansingh, Paolo Lanzetta, Jennifer Lim, Hans LIMBURG, Kaweh Mansouri, Anu Mathew, Alan Morse, Beatriz Munoz, David Musch, Vinay Nangia, MARIA PALAIOU, Maurizio Battaglia Parodi, Fernando Yaacov Pena, Tunde Peto, Harry Quigley, Murugesan Raju, Pradeep Ramulu, Alan Robin, Luca Rossetti, Jinan Saaddine, MYA SANDAR, Janet Serle, Tueng Shen, Rajesh Shetty, Pamela Sieving, Juan Carlos Silva, Rita S Sitorus, Dwight Stambolian, Gretchen Stevens, Hugh Taylor, Jaime Tejedor, James Tielsch, Miltiadis Tsilimbaris, Jan van Meurs, Rohit Varma, Gianni Virgili, Jimmy Volmink, Ya Xing Wang, Ning-Li Wang, Sheila West, Peter Wiedemann, Tien Wong, Richard Wormald, Yingfeng Zheng, Bourne, Rupert R.A., Bron, Alain, Selçuk Üniversitesi, Anglia Ruskin University (ARU), University of Oxford [Oxford], San Raffaele Scientific Institute, Health Education Yorkshire and the Humber, Partenaires INRAE, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University Hospital of Heidelberg, L.V. Prasad Eye Institute, Massachusetts Eye and Ear Infirmary, Medical Center, Nova Southeastern University (NSU), Health Information Services, University of KwaZulu-Natal (UKZN), La Vision, Flinders University, University of New South Wales [Sydney] (UNSW), Royal Liverpool University Hospital, World Health Organization, National University of Singapore (NUS), University of Melbourne, Centre des Sciences du Goût et de l'Alimentation [Dijon] (CSGA), Centre National de la Recherche Scientifique (CNRS)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Université Bourgogne Franche-Comté [COMUE] (UBFC), Bourne, Rra, Flaxman, Sr, Braithwaite, T, Cicinelli, Mv, Das, A, Jonas, Jb, Keeffe, J, Kempen, Jh, Leasher, J, Limburg, H, Naidoo, K, Pesudovs, K, Resnikoff, S, Silvester, A, Stevens, Ga, Tahhan, N, Wong, Ty, Taylor, Hr, on behalf of the Vision Loss Expert, Group, and Battaglia Parodi, M
Subjects: AFRICA, Population ageing, medicine.medical_specialty, Visual acuity, [SDV]Life Sciences [q-bio], Population, Visual impairment, Vision Disorders, Visual Acuity, EYE, Blindness, Global Health, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, [SDV.IDA]Life Sciences [q-bio]/Food engineering, Prevalence, Journal Article, Global health, Humans, Medicine, VISUAL IMPAIRMENT, [SPI.GPROC]Engineering Sciences [physics]/Chemical and Process Engineering, 030212 general & internal medicine, education, Public, Environmental & Occupational Health, education.field_of_study, Science & Technology, business.industry, MORTALITY, Public health, lcsh:Public aspects of medicine, Medicine (all), COST, lcsh:RA1-1270, General Medicine, Presbyopia, medicine.disease, Vision Loss Expert Group, 3. Good health, Meta-analysis, 030221 ophthalmology & optometry, HEALTH, medicine.symptom, business, Life Sciences & Biomedicine, Demography
Abstract: PubMed: 28779882, Background Global and regional prevalence estimates for blindness and vision impairment are important for the development of public health policies. We aimed to provide global estimates, trends, and projections of global blindness and vision impairment. Methods We did a systematic review and meta-analysis of population-based datasets relevant to global vision impairment and blindness that were published between 1980 and 2015. We fitted hierarchical models to estimate the prevalence (by age, country, and sex), in 2015, of mild visual impairment (presenting visual acuity worse than 6/12 to 6/18 inclusive), moderate to severe visual impairment (presenting visual acuity worse than 6/18 to 3/60 inclusive), blindness (presenting visual acuity worse than 3/60), and functional presbyopia (defined as presenting near vision worse than N6 or N8 at 40 cm when best-corrected distance visual acuity was better than 6/12). Findings Globally, of the 7·33 billion people alive in 2015, an estimated 36·0 million (80% uncertainty interval [UI] 12·9–65·4) were blind (crude prevalence 0·48%; 80% UI 0·17–0·87; 56% female), 216·6 million (80% UI 98·5–359·1) people had moderate to severe visual impairment (2·95%, 80% UI 1·34–4·89; 55% female), and 188·5 million (80% UI 64·5–350·2) had mild visual impairment (2·57%, 80% UI 0·88–4·77; 54% female). Functional presbyopia affected an estimated 1094·7 million (80% UI 581·1–1686·5) people aged 35 years and older, with 666·7 million (80% UI 364·9–997·6) being aged 50 years or older. The estimated number of blind people increased by 17·6%, from 30·6 million (80% UI 9·9–57·3) in 1990 to 36·0 million (80% UI 12·9–65·4) in 2015. This change was attributable to three factors, namely an increase because of population growth (38·4%), population ageing after accounting for population growth (34·6%), and reduction in age-specific prevalence (?36·7%). The number of people with moderate and severe visual impairment also increased, from 159·9 million (80% UI 68·3–270·0) in 1990 to 216·6 million (80% UI 98·5–359·1) in 2015. Interpretation There is an ongoing reduction in the age-standardised prevalence of blindness and visual impairment, yet the growth and ageing of the world's population is causing a substantial increase in number of people affected. These observations, plus a very large contribution from uncorrected presbyopia, highlight the need to scale up vision impairment alleviation efforts at all levels. Funding Brien Holden Vision Institute. © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Published: 2017
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21. Inclusive research in ophthalmology is mission critical! The 10-point action plan.

Author: Dinah C, Williams O, Varma D, Reynolds R, Patel PJ, Mulholland P, Ghanchi F, and Bourne RRA
Subjects: Humans, Ophthalmology trends, Biomedical Research trends
Published: 2024
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22. Effective cataract surgical coverage in adults aged 50 years and older: estimates from population-based surveys in 55 countries.

Author: McCormick I, Butcher R, Evans JR, Mactaggart IZ, Limburg H, Jolley E, Sapkota YD, Oye JE, Mishra SK, Bastawrous A, Furtado JM, Joshi A, Xiao B, Ravilla TD, Bourne RRA, Cieza A, Keel S, Burton MJ, and Ramke J
Subjects: Male, Adult, Humans, Female, Middle Aged, Aged, Blindness epidemiology, Global Health, Health Surveys, Prevalence, Cataract Extraction, Cataract epidemiology, Cataract complications
Abstract: Background: Cataract is the leading cause of blindness globally. Effective cataract surgical coverage (eCSC) measures the number of people in a population who have been operated on for cataract, and had a good outcome, as a proportion of all people operated on or requiring surgery. Therefore, eCSC describes service access (ie, cataract surgical coverage, [CSC]) adjusted for quality. The 74th World Health Assembly endorsed a global target for eCSC of a 30-percentage point increase by 2030. To enable monitoring of progress towards this target, we analysed Rapid Assessment of Avoidable Blindness (RAAB) survey data to establish baseline estimates of eCSC and CSC., Methods: In this secondary analysis, we used data from 148 RAAB surveys undertaken in 55 countries (2003-21) to calculate eCSC, CSC, and the relative quality gap (% difference between eCSC and CSC). Eligible studies were any version of the RAAB survey conducted since 2000 with individual participant survey data and census population data for people aged 50 years or older in the sampling area and permission from the study's principal investigator for use of data. We compared median eCSC between WHO regions and World Bank income strata and calculated the pooled risk difference and risk ratio comparing eCSC in men and women., Findings: Country eCSC estimates ranged from 3·8% (95% CI 2·1-5·5) in Guinea Bissau, 2010, to 70·3% (95% CI 65·8-74·9) in Hungary, 2015, and the relative quality gap from 10·8% (CSC: 65·7%, eCSC: 58·6%) in Argentina, 2013, to 73·4% (CSC: 14·3%, eCSC: 3·8%) in Guinea Bissau, 2010. Median eCSC was highest among high-income countries (60·5% [IQR 55·6-65·4]; n=2 surveys; 2011-15) and lowest among low-income countries (14·8%; [IQR 8·3-20·7]; n=14 surveys; 2005-21). eCSC was higher in men than women (148 studies pooled risk difference 3·2% [95% CI 2·3-4·1] and pooled risk ratio of 1·20 [95% CI 1·15-1·25])., Interpretation: eCSC varies widely between countries, increases with greater income level, and is higher in men. In pursuit of 2030 targets, many countries, particularly in lower-resource settings, should emphasise quality improvement before increasing access to surgery. Equity must be embedded in efforts to improve access to surgery, with a focus on underserved groups., Funding: Indigo Trust, Peek Vision, and Wellcome Trust., Competing Interests: Declaration of interests MJB declares funding support from the Wellcome Trust (207472/Z/17/Z) via a grant to the London School of Hygiene & Tropical Medicine. AB declares funding from the Wellcome Trust (215633/Z/19/Z); and declares being the Co-Founder and Chief Executive Officer of both the Peek Vision Foundation (UK charity number 1165960) and Peek Vision (UK company number 09937174) which is a wholly owned subsidiary of the Peek Vision Foundation. IM, RB, and IZM declare funding support from Peek Vision via a grant to the London School of Hygiene & Tropical Medicine. JMF declares consulting fees as a technical adviser for SightFirst/Lions Club International Latin America. All other authors declare no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
Published: 2022
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23. Effective refractive error coverage in adults aged 50 years and older: estimates from population-based surveys in 61 countries.

Author: Bourne RRA, Cicinelli MV, Sedighi T, Tapply IH, McCormick I, Jonas JB, Congdon NG, Ramke J, Naidoo KS, Fricke TR, Burton MJ, Müller A, Bikbov MM, Furtado JM, Kyari F, He M, Wang YX, Vijaya L, Nangia V, Brian G, Emamian MH, Fotouhi A, Hashemi H, Khandekar RB, Marmamula S, Salomão S, George R, Kazakbaeva G, Braithwaite T, Casson RJ, Iwase A, Gupta N, Abdianwall MH, Varma R, Wong TY, Wang N, Taylor HR, Flaxman SR, Keel S, and Resnikoff S
Subjects: Adult, Male, Humans, Middle Aged, Aged, Global Burden of Disease, Africa South of the Sahara, Europe, Global Health, Refractive Errors epidemiology, Refractive Errors therapy
Abstract: Background: In 2021, WHO Member States endorsed a global target of a 40-percentage-point increase in effective refractive error coverage (eREC; with a 6/12 visual acuity threshold) by 2030. This study models global and regional estimates of eREC as a baseline for the WHO initiative., Methods: The Vision Loss Expert Group analysed data from 565 448 participants of 169 population-based eye surveys conducted since 2000 to calculate eREC (met need/[met need + undermet need + unmet need]). A binary logistic regression model was used to estimate eREC by Global Burden of Disease (GBD) Study super region among adults aged 50 years and older., Findings: In 2021, distance eREC was 79·1% (95% CI 72·4-85·0) in the high-income super region; 62·1% (54·7-68·8) in north Africa and Middle East; 49·5% (45·0-54·0) in central Europe, eastern Europe, and central Asia; 40·0% (31·7-48·2) in southeast Asia, east Asia, and Oceania; 34·5% (29·4-40·0) in Latin America and the Caribbean; 9·0% (6·5-12·0) in south Asia; and 5·7% (3·1-9·0) in sub-Saharan Africa. eREC was higher in men and reduced with increasing age. Global distance eREC increased from 2000 to 2021 by 19·0%. Global near vision eREC for 2021 was 20·5% (95% CI 17·8-24·4)., Interpretation: Over the past 20 years, distance eREC has increased in each super region yet the WHO target will require substantial improvements in quantity and quality of refractive services in particular for near vision impairment., Funding: WHO, Sightsavers, The Fred Hollows Foundation, Fondation Thea, Brien Holden Vision Institute, Lions Clubs International Foundation., Competing Interests: Declaration of interests JR reports university position funding by Buchanan Charitable Foundation, New Zealand. KSN reports employment by OneSight EssilorLuxottica Foundation. JMF reports research grants from Lions SightFirst & Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil. Tecnológico, Brazil. RV reports the Los Angeles Latino Eye Study research grant from the National Eye Institute, where he participates on a Data Monitoring Board or Advisory Board. The remaining authors declare no competing interests. The remaining authors declare no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
Published: 2022
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24. Trainee research network (TRN): a potential global model for promoting research training and outputs among trainees.

Author: Ong ZZ, Henein C, Swampillai AJ, Maubon L, Bourne RRA, and Ting DSJ
Subjects: Humans, Education, Medical, Graduate, Clinical Competence
Published: 2022
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25. Evaluating multidisciplinary glaucoma care: visual field progression and loss of sight year analysis in the community vs hospital setting.

Author: Mushtaq Y, Panchasara B, Nassehzadehtabriz N, Lim HK, Mushtaq M, Kean J, Farrell S, Bourne RRA, Shahid H, Khatib TZ, and Martin KR
Subjects: Disease Progression, Hospitals, Humans, Intraocular Pressure, Retrospective Studies, Vision Disorders diagnosis, Vision Disorders epidemiology, Visual Field Tests, Glaucoma diagnosis, Glaucoma therapy, Visual Fields
Abstract: Background: A variety of shared care models have been developed, which aim to stratify glaucoma patients according to risk of disease progression. However, there is limited published data on the rate of glaucoma progression in the hospital vs community setting. Here we aimed to compare rates of glaucomatous visual field progression in the Cambridge Community Optometrist Glaucoma Scheme (COGS) and Addenbrooke's Hospital Glaucoma Clinic (AGC)., Methods: A retrospective comparative cohort review was performed. Patients with five or more visual field tests were included. Zeiss Forum software was used to calculate the MD progression rate (dB/year). Loss of sight years (LSY) were also calculated for both COGS and AGC., Results: Overall, 8465 visual field tests from 854 patients were reviewed. In all, 362 eyes from the AGC group and 210 eyes from COGS were included. The MD deterioration rate was significantly lower in the COGS patients compared with the AGC group (-0.1 vs -0.3 dB/year; p < 0.0001). No patients in the COGS group were predicted to become blind within their lifetime by LSY analysis. Fifteen patients were at risk in the AGC group., Conclusion: This service evaluation shows that COGS is an effective scheme to stratify lower risk glaucoma patients, increasing the capacity within hospital eye services. COGS patients have a lower rate of visual field deterioration compared to AGC patients. Effective communication between community and tertiary schemes is essential to facilitate transfer of patients requiring further hospital management reliably and efficiently, with the potential for low-risk patients to be followed safely in the community., (© 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)
Published: 2022
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26. Association between digital smart device use and myopia: a systematic review and meta-analysis.

Author: Foreman J, Salim AT, Praveen A, Fonseka D, Ting DSW, Guang He M, Bourne RRA, Crowston J, Wong TY, and Dirani M
Subjects: Adolescent, Adult, Cell Phone Use, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Risk Factors, Social Media, Young Adult, Computers, Myopia etiology, Screen Time, Smartphone, Vision, Ocular
Abstract: Background: Excessive use of digital smart devices, including smartphones and tablet computers, could be a risk factor for myopia. We aimed to review the literature on the association between digital smart device use and myopia., Methods: In this systematic review and meta-analysis we searched MEDLINE and Embase, and manually searched reference lists for primary research articles investigating smart device (ie, smartphones and tablets) exposure and myopia in children and young adults (aged 3 months to 33 years) from database inception to June 2 (MEDLINE) and June 3 (Embase), 2020. We included studies that investigated myopia-related outcomes of prevalent or incident myopia, myopia progression rate, axial length, or spherical equivalent. Studies were excluded if they were reviews or case reports, did not investigate myopia-related outcomes, or did not investigate risk factors for myopia. Bias was assessed with the Joanna Briggs Institute Critical Appraisal Checklists for analytical cross-sectional and cohort studies. We categorised studies as follows: category one studies investigated smart device use independently; category two studies investigated smart device use in combination with computer use; and category three studies investigated smart device use with other near-vision tasks that were not screen-based. We extracted unadjusted and adjusted odds ratios (ORs), β coefficients, prevalence ratios, Spearman's correlation coefficients, and p values for associations between screen time and incident or prevalent myopia. We did a meta-analysis of the association between screen time and prevalent or incident myopia for category one articles alone and for category one and two articles combined. Random-effects models were used when study heterogeneity was high (I 2 >50%) and fixed-effects models were used when heterogeneity was low (I 2 ≤50%)., Findings: 3325 articles were identified, of which 33 were included in the systematic review and 11 were included in the meta-analysis. Four (40%) of ten category one articles, eight (80%) of ten category two articles, and all 13 category three articles used objective measures to identify myopia (refraction), whereas the remaining studies used questionnaires to identify myopia. Screen exposure was measured by use of questionnaires in all studies, with one also measuring device-recorded network data consumption. Associations between screen exposure and prevalent or incident myopia, an increased myopic spherical equivalent, and longer axial length were reported in five (50%) category one and six (60%) category two articles. Smart device screen time alone (OR 1·26 [95% CI 1·00-1·60]; I 2 =77%) or in combination with computer use (1·77 [1·28-2·45]; I 2 =87%) was significantly associated with myopia. The most common sources of risk of bias were that all 33 studies did not include reliable measures of screen time, seven (21%) did not objectively measure myopia, and nine (27%) did not identify or adjust for confounders in the analysis. The high heterogeneity between studies included in the meta-analysis resulted from variability in sample size (range 155-19 934 participants), the mean age of participants (3-16 years), the standard error of the estimated odds of prevalent or incident myopia (0·02-2·21), and the use of continuous (six [55%] of 11) versus categorical (five [46%]) screen time variables INTERPRETATION: Smart device exposure might be associated with an increased risk of myopia. Research with objective measures of screen time and myopia-related outcomes that investigates smart device exposure as an independent risk factor is required., Funding: None., Competing Interests: Declaration of interests JF, ATS, and DF are employees of Plano. AP was an employee of Plano at the time of writing. JC is a shareholder in Plano. MD is the co-founder, a shareholder, and the current managing director of Plano. Plano is a health technology start-up that was created as part of the Singapore Eye Research Institute-Singapore National Eye Centre Ophthalmic Technologies Incubator Programme to develop evidence-based technological and educational solutions to address the global burden of myopia. In accordance with policies of the Singapore National Eye Centre, TYW has received grants, contracts, consulting fees, honoraria, and travel support from, and has participated on advisory boards for Allergan, Bayer, Boehringer Ingelheim, Eden Ophthalmic, Genentech, Iveric Bio, Merck, Novartis, Oxurion (ThromboGenics), Roche, Samsung, Shanghai Henlius, and Zhaoke Pharmaceutical. TYW is the co-founder of Plano and EyRiS. The commercial relationships have not influenced the methods used in this study. All evidence has been presented and appraised in a balanced manner, and all data have been collected and analysed rigorously and without bias. DSWT, MGH, and RRAB declare no competing interests., (Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
Published: 2021
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27. Self-reported visual difficulties in Europe and related factors: a European population-based cross-sectional survey.

Author: Leveziel N, Marillet S, Braithwaite T, Peto T, Ingrand P, Pardhan S, Bron AM, Jonas JB, Resnikoff S, Little JA, and Bourne RRA
Subjects: Adolescent, Adult, Aged, Cross-Sectional Studies, Educational Status, Europe epidemiology, Female, Humans, Male, Middle Aged, Prevalence, Retrospective Studies, Risk Factors, Socioeconomic Factors, Vision Disorders economics, Vision Disorders physiopathology, Young Adult, Health Surveys methods, Risk Assessment methods, Self Report, Vision Disorders epidemiology, Visual Acuity
Abstract: Purpose: There is a relative paucity of self-reported vision problems data in European countries., Methods: In this context, we investigated self-reported vision problems through European Health Interview Survey 2, a cross-sectional European population survey based on a standardized questionnaire including 147 medical, demographic and socioeconomic variables applied to non-institutionalized individuals aged 15 years or more in 28 European countries, in addition to Iceland and Norway., Results: The survey included 311 386 individuals (54.18% women), with overall crude prevalence of self-reported vision problems of 2.07% [95% CI; 2.01-2.14]. Among them, 1.70 % [1.61-1.78] of men, 2.41% [2.31-2.51] of women and 4.71% [4.53-4.89] of individuals aged 60 or more reported to have a lot of vision problems or to be not able to see. The frequency of self-reported vision problems was the highest in Eastern European countries with values of 2.43% [2.30-2.56]. In multivariate analyses, limiting long-standing illness, depression, daily smoking, lack of physical activity, lower educational level and social isolation were associated with self-reported vision problems with ORs of 2.66 [2.42-2.92], 2.16 [2.01-2.32], 1.11 [1.01-1.23], 1.31 [1.21-1.42], 1.29 [1.19-1.40] and 1.45 [1.26-1.67], respectively, while higher income was associated with less self-reported vision problems with OR of 0.80 [0.73-0.86]., Conclusions: This study demonstrated inequalities in terms of prevalence of self-reported vision problems in Europe, with higher prevalence in Eastern European countries and among women and older individuals., (© 2020 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta OphthalmologicaScandinavica Foundation.)
Published: 2021
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28. Visual function rather than visual acuity - Authors' reply.

Author: Kyari F, Bourne RRA, Khaw PT, Friedman DS, Congdon N, Ramke J, and Burton MJ
Subjects: Humans, Visual Acuity
Abstract: Competing Interests: NC reports professional fees from Belkin Laser. All other authors declare no competing interests.
Published: 2021
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29. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020.

Author: Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, Ah Tong BAM, Arunga S, Bachani D, Bascaran C, Bastawrous A, Blanchet K, Braithwaite T, Buchan JC, Cairns J, Cama A, Chagunda M, Chuluunkhuu C, Cooper A, Crofts-Lawrence J, Dean WH, Denniston AK, Ehrlich JR, Emerson PM, Evans JR, Frick KD, Friedman DS, Furtado JM, Gichangi MM, Gichuhi S, Gilbert SS, Gurung R, Habtamu E, Holland P, Jonas JB, Keane PA, Keay L, Khanna RC, Khaw PT, Kuper H, Kyari F, Lansingh VC, Mactaggart I, Mafwiri MM, Mathenge W, McCormick I, Morjaria P, Mowatt L, Muirhead D, Murthy GVS, Mwangi N, Patel DB, Peto T, Qureshi BM, Salomão SR, Sarah V, Shilio BR, Solomon AW, Swenor BK, Taylor HR, Wang N, Webson A, West SK, Wong TY, Wormald R, Yasmin S, Yusufu M, Silva JC, Resnikoff S, Ravilla T, Gilbert CE, Foster A, and Faal HB
Subjects: Advisory Committees organization & administration, Blindness economics, Blindness etiology, Cost of Illness, Eye Diseases complications, Eye Diseases diagnosis, Eye Diseases epidemiology, Global Burden of Disease economics, Health Services Accessibility economics, Humans, Quality of Health Care economics, Quality of Health Care organization & administration, Quality of Life, Blindness prevention & control, Eye Diseases therapy, Global Health, Health Services Accessibility organization & administration, Sustainable Development
Published: 2021
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30. Estimating the global cost of vision impairment and its major causes: protocol for a systematic review.

Author: Marques AP, Ramke J, Cairns J, Butt T, Zhang JH, Faal HB, Taylor H, Jones I, Congdon N, Bastawrous A, Braithwaite T, Jovic M, Resnikoff S, Nandakumar A, Khaw PT, Bourne RRA, Gordon I, Frick K, and Burton MJ
Subjects: Causality, Cost-Benefit Analysis, Delivery of Health Care, Humans, Meta-Analysis as Topic, Review Literature as Topic, Research Design, State Medicine
Abstract: Introduction: Vision impairment (VI) places a burden on individuals, health systems and society in general. In order to support the case for investing in eye health services, an updated cost of illness study that measures the global impact of VI is necessary. To perform such a study, a systematic review of the literature is needed. Here we outline the protocol for a systematic review to describe and summarise the costs associated with VI and its major causes., Methods and Analysis: We will systematically search in Medline (Ovid) and the Centre for Reviews and Dissemination database which includes the National Health Service Economics Evaluation Database. No language or geographical restriction will be applied. Additional literature will be identified by reviewing the references in the included studies and by contacting field experts. Grey literature will be considered. The review will include any study published from 1 January 2000 to November 2019 that provides information about costs of illness, burden of disease and/or loss of well-being in participants with VI due to an unspecified cause or due to one of the seven leading causes globally.Two reviewers will independently screen studies and extract relevant data from included studies. Methodological quality of economic studies will be assessed based on the British Medical Journal checklist for economic submissions adapted to costs of illness studies. This protocol has been prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols and has been published prospectively in Open Science Framework., Ethics and Dissemination: Formal ethical approval is not required, as primary data will not be collected in this review. The findings of this study will be disseminated through peer-reviewed publications, stakeholder meetings and inclusion in the ongoing Lancet Global Health Commission on Global Eye Health. REGISTRATION DETAILS: https://osf.io/9au3w (DOI 10.17605/OSF.IO/6F8VM)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)
Published: 2020
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31. Announcing The Lancet Global Health Commission on Global Eye Health.

Author: Burton MJ, Faal HB, Ramke J, Ravilla T, Holland P, Wang N, West SK, Bourne RRA, Congdon NG, and Foster A
Subjects: Humans, Eye Diseases prevention & control, Global Health, Periodicals as Topic
Published: 2019
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32. Lessons learned from the development and implementation of a patient-reported outcome and experience measure (POEM) in an Australian glaucoma practice.

Author: Fraenkel A, Lee GA, Vincent SJ, Vincent RA, Bourne RRA, and Shah P
Subjects: Activities of Daily Living, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Glaucoma epidemiology, Glaucoma physiopathology, Humans, Male, Middle Aged, Morbidity trends, Prospective Studies, Quality of Life, Queensland epidemiology, Surveys and Questionnaires, Young Adult, Glaucoma therapy, Intraocular Pressure physiology, Patient Reported Outcome Measures, Quality of Health Care, Visual Acuity, Visual Fields physiology
Abstract: Background: A patient's perception of how their glaucoma is managed will influence both adherence to their medication and outcome measures such as quality of life., Methods: Prospective consecutive study using a Glaucoma Patient-reported Outcome and Experience Measure (POEM) modified for an Australian ophthalmic private clinical practice setting. The Australian Glaucoma POEM consists of eight items related to the patient's understanding of the diagnosis and management, acceptability of the treatment, whether they feel their glaucoma is getting worse, interfering with their daily life and concerns regarding loss of vision as well as addressing whether they feel safe under the care of their glaucoma team and how well their care is organised., Results: Two hundred and two patients (M:F 91:111) participated in the study. Mean ± standard deviation for subject age was 69 ± 13 years. Patient's overall perception of their treatment and outcome was favourable. Younger patients felt their glaucoma interfered more with their daily lives and were more worried about losing vision from glaucoma. The greater the number of medications in use, the more they felt their glaucoma was getting worse and that glaucoma interfered with their daily lives. With all other variables accounted for by the multivariate linear model, female patients more strongly agreed that they understood their glaucoma diagnosis and glaucoma management. The patients with a severe visual defect in their worse eye, reported a greater perceived understanding of their glaucoma diagnosis and management and that they felt that glaucoma had a greater interference on their daily life. They were also more concerned about losing vision from glaucoma than their fellow glaucoma patients with less severe or no visual field deficit in the worse eye., Conclusions: The modified POEM demonstrates potential to capture the concerns of a practice's glaucoma cohort with a view to enhancing the quality of glaucoma care delivered.
Published: 2019
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33. Changes in ocular signs and symptoms in patients switching from bimatoprost-timolol to tafluprost-timolol eye drops: an open-label phase IV study.

Author: Bourne RRA, Kaarniranta K, Lorenz K, Traverso CE, Vuorinen J, and Ropo A
Subjects: Adult, Aged, Aged, 80 and over, Antihypertensive Agents adverse effects, Bimatoprost adverse effects, Drug Administration Schedule, Drug Combinations, Female, Humans, Intention to Treat Analysis, Intraocular Pressure drug effects, Male, Middle Aged, Ophthalmic Solutions, Preservatives, Pharmaceutical, Prostaglandins F adverse effects, Quality of Life, Timolol adverse effects, Antihypertensive Agents administration & dosage, Bimatoprost administration & dosage, Glaucoma, Open-Angle drug therapy, Ocular Hypertension drug therapy, Prostaglandins F administration & dosage, Timolol administration & dosage
Abstract: Objectives: Bimatoprost-timolol (bimatoprost 0.03%-timolol 0.5% fixed-dose combination [FDC]) and tafluprost-timolol (tafluprost 0.0015%-timolol 0.5% FDC) eye drops are currently the only topical intraocular pressure (IOP)-reducing therapies available as preservative-free (PF) prostaglandin and timolol FDC. The aim of this study was to investigate changes to ocular signs and symptoms when patients with ocular hypertension (OH) or open-angle glaucoma (OAG) switched from PF or benzalkonium chloride (BAK)-preserved bimatoprost-timolol to PF tafluprost-timolol eye drops., Design: This was a 12-week, open-label, phase IV study., Setting: Sixteen centres in Finland, Germany, Italy and the UK., Participants: Patients with OH or OAG (IOP on medication ≤21 mm Hg), treated with PF or BAK-preserved bimatoprost-timolol for ≥4 weeks before screening, and presenting with conjunctival hyperaemia and ≥1 ocular symptom., Interventions: Patients were switched to PF tafluprost-timolol once daily in the treated eye(s)., Primary and Secondary Outcome Measures: The primary endpoints were change from screening to week 12 in conjunctival hyperaemia and worst ocular symptom. The secondary outcome measures were changes from screening in ocular signs (other than conjunctival hyperaemia) and symptoms at week 12., Results: Of 123 enrolled patients, 121 were included in the intention-to-treat dataset, of which all were Caucasian and 54.5% were female; 76 patients used BAK-preserved bimatoprost-timolol and 45 used PF drops. Conjunctival hyperaemia and severity of worst ocular symptom following switch to PF tafluprost-timolol significantly reduced from screening to week 12 in all patients (p<0.001). The percentage of patients with ocular signs and symptoms was significantly reduced at week 12 compared with screening (p<0.001). IOP was not affected by the change of treatment., Conclusions: Switching from BAK-preserved or PF bimatoprost-timolol to tafluprost-timolol reduced both signs and symptoms of ocular surface disease with no clinically relevant effect on IOP., Trial Registration Number: EudraCT2014-005273-37; Results., Competing Interests: Competing interests: RRAB has received travel expenses from Santen. KK has received a consultant fee from Santen for an advisory board. KL has no conflicts of interest to report. CET has received department funding for the conduction of this study, personal fees and non-financial support from Santen not related to this study or manuscript, and department funding from Novartis and Allergan. JV has received fees for statistical services from Santen. AR is an employee at Santen Oy., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Published: 2019
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34. Ophthalmology research in the UK's National Health Service: the structure and performance of the NIHR's Ophthalmology research portfolio.

Author: Dawson SR, Linton E, Beicher K, Gale R, Patel P, Ghanchi F, Beresford MW, Poustie V, Chakravarthy U, and Bourne RRA
Subjects: Humans, United Kingdom, Biomedical Research organization & administration, Ophthalmology organization & administration, State Medicine
Abstract: Purpose: To report on the composition and performance of the portfolio of Ophthalmology research studies in the United Kingdom's National Institute for Health Research (NIHR) Clinical Research Network (UK CRN)., Methods: Ophthalmology studies open to recruitment between 1 April 2010 and 31 March 2018 were classified by: sub-specialty, participant age, gender of Chief Investigator, involvement of genetic investigations, commercial/ non-commercial, interventional/observational design. Frequency distributions for each covariate and temporal variation in recruitment to time and target were analysed., Results: Over 8 years, 137,377 participants were recruited (average of 15,457 participants/year; range: 5485-32,573) with growth by year in proportion of commercial studies and hospital participation in England (76% in 2017/18). Fourteen percent of studies had a genetic component and most studies (82%) included only adults. The majority of studies (41%) enrolled patients with retinal diseases, followed by glaucoma (17%), anterior segment and cataract (13%), and ocular inflammation (6%). Overall, 68% of non-commercial studies and 55% of commercial studies recruited within the anticipated time set by the study and also recruited to or exceeded the target number of participants., Conclusions: High levels of clinical research activity, growth and improved performance have been observed in Ophthalmology in UK over the past 8 years. Some sub-specialties that carry substantial morbidity and a very high burden on NHS services are underrepresented and deserve more patient-centred research. Yet the NIHR and its CRN Ophthalmology National Specialty Group has enabled key steps in achieving the goal of embedding research into every day clinical care.
Published: 2019
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35. The feasibility of finger prick autologous blood (FAB) as a novel treatment for severe dry eye disease (DED): protocol for a randomised controlled trial.

Author: Balal S, Udoh A, Pappas Y, Cook E, Barton G, Hassan A, Hayden K, Bourne RRA, Ahmad S, Pardhan S, Harrison M, Sharma B, Wasil M, and Sharma A
Subjects: England, Feasibility Studies, Humans, Multicenter Studies as Topic, Ophthalmic Solutions therapeutic use, Proportional Hazards Models, Quality of Life, Randomized Controlled Trials as Topic, Severity of Illness Index, Single-Blind Method, Sodium Chloride therapeutic use, Visual Acuity, Dry Eye Syndromes therapy, Lubricant Eye Drops therapeutic use, Serum
Abstract: Introduction: Patients with severe dry eye disease (DED) often have limited treatment options with standard non-surgical management focused on the use of artificial tears for lubrication and anti-inflammatory drugs. However, artificial tears do not address the extraordinary complexity of human tears. Crudely, human tears with its vast constituents is essentially filtered blood. Blood and several blood-derived products including autologous serum, have been studied as tear substitutes. This study proposes to test the use of whole, fresh, autologous blood obtained from a finger prick for treatment of severe DED., Methods and Analysis: The research team at the two participating sites will approach patients with severe DED for this study. Recruitment will take place over 12 months and we expect to recruit 60 patients in total. The primary outcome of this feasibility study is to estimate the proportion of eligible patients approached who consent to and comply with study procedures including treatment regimen and completion of required questionnaires. The secondary outcome measures, although not powered for in this feasibility, include corneal inflammation (assessed by the Oxford corneal staining guide), patient pain and symptoms scores (assessed by the Ocular Surface Disease Index Score), and objective signs of DED as indicated by visual acuity (assessed by Schirmer's test, tear break-up time, lower and/or upper tear meniscus height measurement). Other secondary outcomes include patients' quality of life (assessed using the validated EQ-5D-5L Questionnaire), cost to the National Health Service (NHS) and patient (assessed via use of NHS services and privately purchased over-the-counter treatment related to DED) and safety measure of pressure within the eye (assessed by the Intraocular Pressure (IOP) Score)., Ethics and Dissemination: This protocol and any subsequent amendments, along with any accompanying material provided to the participant in addition to any advertising material used in this trial have been approved by the East of England - Cambridgeshire and Hertfordshire Research Ethics Committee (REC reference: 17/EE/0508). Written approval from the committee was obtained and subsequently submitted to the respective Trust's Research and Development (R&D) office with final NHS R&D approval obtained. Data obtained from this study will be published in a suitable peer-review journal and will also presented at international ophthalmic conferences including the American Academy of Ophthalmology, the Royal College of Ophthalmology Annual Congress, the Association for Research and Vision and Ophthalmology, and the European Society of Cataract and Refractive Surgery. Information will be provided to patient groups and charities such as the Sjogren's Society and the Royal National Institute of Blind People. This will also be shared with the study participants as well as with relevant patient groups and charities., Trial Registration Number: NCT03395431; Pre-results., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY. Published by BMJ.)
Published: 2018
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36. Health system dynamics analysis of eyecare services in Trinidad and Tobago and progress towards Vision 2020 Goals.

Author: Braithwaite T, Winford B, Bailey H, Bridgemohan P, Bartholomew D, Singh D, Sharma S, Sharma R, Silva JC, Gray A, Ramsewak SS, and Bourne RRA
Subjects: Adult, Aged, Aged, 80 and over, Blindness prevention & control, Eye Diseases epidemiology, Eye Diseases surgery, Female, Health Expenditures statistics & numerical data, Humans, Male, Middle Aged, Ophthalmologists statistics & numerical data, Ophthalmology economics, Ophthalmology instrumentation, Optometrists statistics & numerical data, Outpatients, Surveys and Questionnaires, Trinidad and Tobago, Workforce, Ophthalmology organization & administration, Systems Analysis
Abstract: Avoidable blindness is an important global public health concern. This study aimed to assess Trinidad and Tobago's progress towards achieving the Pan American Health Organization, 'Strategic Framework for Vision 2020: The Right to Sight-Caribbean Region,' indicators through comprehensive review of the eyecare system, in order to facilitate health system priority setting. We administered structured surveys to six stakeholder groups, including eyecare providers, patients and older adult participants in the National Eye Survey of Trinidad and Tobago. We reviewed reports, registers and policy documents, and used a health system dynamics framework to synthesize data. In 2014, the population of 1.3 million were served by a pluralistic eyecare system, which had achieved 14 out of 27 Strategic Framework indicators. The Government provided free primary, secondary and emergency eyecare services, through 108 health centres and 5 hospitals (0.26 ophthalmologists and 1.32 ophthalmologists-in-training per 50 000 population). Private sector optometrists (4.37 per 50 000 population), and ophthalmologists (0.93 per 50 000 population) provided 80% of all eyecare. Only 19.3% of the adult population had private health insurance, revealing significant out-of-pocket expenditure. We identified potential weaknesses in the eyecare system where investment might reduce avoidable blindness. These included a need for more ophthalmic equipment and maintenance in the public sector, national screening programmes for diabetic retinopathy, retinopathy of prematurity and neonatal eye defects, and pathways to ensure timely and equitable access to subspecialized surgery. Eyecare for older adults was responsible for an estimated 9.5% (US$22.6 million) of annual health expenditure. This study used the health system dynamics framework and new data to identify priorities for eyecare system strengthening. We recommend this approach for exploring potential health system barriers to addressing avoidable blindness, and other important public health problems., (© The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Published: 2018
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37. Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis.

Author: Flaxman SR, Bourne RRA, Resnikoff S, Ackland P, Braithwaite T, Cicinelli MV, Das A, Jonas JB, Keeffe J, Kempen JH, Leasher J, Limburg H, Naidoo K, Pesudovs K, Silvester A, Stevens GA, Tahhan N, Wong TY, and Taylor HR
Subjects: Cataract complications, Diabetic Retinopathy complications, Glaucoma complications, Humans, Macular Degeneration complications, Prevalence, Visual Acuity, Aging, Blindness etiology, Global Health
Abstract: Background: Contemporary data for causes of vision impairment and blindness form an important basis of recommendations in public health policies. Refreshment of the Global Vision Database with recently published data sources permitted modelling of cause of vision loss data from 1990 to 2015, further disaggregation by cause, and forecasts to 2020., Methods: In this systematic review and meta-analysis, we analysed published and unpublished population-based data for the causes of vision impairment and blindness from 1980 to 2014. We identified population-based studies published before July 8, 2014, by searching online databases with no language restrictions (MEDLINE from Jan 1, 1946, and Embase from Jan 1, 1974, and the WHO Library Database). We fitted a series of regression models to estimate the proportion of moderate or severe vision impairment (defined as presenting visual acuity of <6/18 but ≥3/60 in the better eye) and blindness (presenting visual acuity of <3/60 in the better eye) by cause, age, region, and year., Findings: We identified 288 studies of 3 983 541 participants contributing data from 98 countries. Among the global population with moderate or severe vision impairment in 2015 (216·6 million [80% uncertainty interval 98·5 million to 359·1 million]), the leading causes were uncorrected refractive error (116·3 million [49·4 million to 202·1 million]), cataract (52·6 million [18·2 million to 109·6 million]), age-related macular degeneration (8·4 million [0·9 million to 29·5 million]), glaucoma (4·0 million [0·6 million to 13·3 million]), and diabetic retinopathy (2·6 million [0·2 million to 9·9 million]). Among the global population who were blind in 2015 (36·0 million [12·9 million to 65·4 million]), the leading causes were cataract (12·6 million [3·4 million to 28·7 million]), uncorrected refractive error (7·4 million [2·4 million to 14·8 million]), and glaucoma (2·9 million [0·4 million to 9·9 million]). By 2020, among the global population with moderate or severe vision impairment (237·1 million [101·5 million to 399·0 million]), the number of people affected by uncorrected refractive error is anticipated to rise to 127·7 million (51·0 million to 225·3 million), by cataract to 57·1 million (17·9 million to 124·1 million), by age-related macular degeneration to 8·8 million (0·8 million to 32·1 million), by glaucoma to 4·5 million (0·5 million to 15·4 million), and by diabetic retinopathy to 3·2 million (0·2 million to 12·9 million). By 2020, among the global population who are blind (38·5 million [13·2 million to 70·9 million]), the number of patients blind because of cataract is anticipated to rise to 13·4 million (3·3 million to 31·6 million), because of uncorrected refractive error to 8·0 million (2·5 million to 16·3 million), and because of glaucoma to 3·2 million (0·4 million to 11·0 million). Cataract and uncorrected refractive error combined contributed to 55% of blindness and 77% of vision impairment in adults aged 50 years and older in 2015. World regions varied markedly in the causes of blindness and vision impairment in this age group, with a low prevalence of cataract (<22% for blindness and 14·1-15·9% for vision impairment) and a high prevalence of age-related macular degeneration (>14% of blindness) as causes in the high-income subregions. Blindness and vision impairment at all ages in 2015 due to diabetic retinopathy (odds ratio 2·52 [1·48-3·73]) and cataract (1·21 [1·17-1·25]) were more common among women than among men, whereas blindness and vision impairment due to glaucoma (0·71 [0·57-0·86]) and corneal opacity (0·54 [0·43-0·66]) were more common among men than among women, with no sex difference related to age-related macular degeneration (0·91 [0·70-1·14])., Interpretation: The number of people affected by the common causes of vision loss has increased substantially as the population increases and ages. Preventable vision loss due to cataract (reversible with surgery) and refractive error (reversible with spectacle correction) continue to cause most cases of blindness and moderate or severe vision impairment in adults aged 50 years and older. A large scale-up of eye care provision to cope with the increasing numbers is needed to address avoidable vision loss., Funding: Brien Holden Vision Institute., (Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
Published: 2017
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38. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis.

Author: Bourne RRA, Flaxman SR, Braithwaite T, Cicinelli MV, Das A, Jonas JB, Keeffe J, Kempen JH, Leasher J, Limburg H, Naidoo K, Pesudovs K, Resnikoff S, Silvester A, Stevens GA, Tahhan N, Wong TY, and Taylor HR
Subjects: Humans, Prevalence, Visual Acuity, Blindness epidemiology, Global Health statistics & numerical data, Vision Disorders epidemiology
Abstract: Background: Global and regional prevalence estimates for blindness and vision impairment are important for the development of public health policies. We aimed to provide global estimates, trends, and projections of global blindness and vision impairment., Methods: We did a systematic review and meta-analysis of population-based datasets relevant to global vision impairment and blindness that were published between 1980 and 2015. We fitted hierarchical models to estimate the prevalence (by age, country, and sex), in 2015, of mild visual impairment (presenting visual acuity worse than 6/12 to 6/18 inclusive), moderate to severe visual impairment (presenting visual acuity worse than 6/18 to 3/60 inclusive), blindness (presenting visual acuity worse than 3/60), and functional presbyopia (defined as presenting near vision worse than N6 or N8 at 40 cm when best-corrected distance visual acuity was better than 6/12)., Findings: Globally, of the 7·33 billion people alive in 2015, an estimated 36·0 million (80% uncertainty interval [UI] 12·9-65·4) were blind (crude prevalence 0·48%; 80% UI 0·17-0·87; 56% female), 216·6 million (80% UI 98·5-359·1) people had moderate to severe visual impairment (2·95%, 80% UI 1·34-4·89; 55% female), and 188·5 million (80% UI 64·5-350·2) had mild visual impairment (2·57%, 80% UI 0·88-4·77; 54% female). Functional presbyopia affected an estimated 1094·7 million (80% UI 581·1-1686·5) people aged 35 years and older, with 666·7 million (80% UI 364·9-997·6) being aged 50 years or older. The estimated number of blind people increased by 17·6%, from 30·6 million (80% UI 9·9-57·3) in 1990 to 36·0 million (80% UI 12·9-65·4) in 2015. This change was attributable to three factors, namely an increase because of population growth (38·4%), population ageing after accounting for population growth (34·6%), and reduction in age-specific prevalence (-36·7%). The number of people with moderate and severe visual impairment also increased, from 159·9 million (80% UI 68·3-270·0) in 1990 to 216·6 million (80% UI 98·5-359·1) in 2015., Interpretation: There is an ongoing reduction in the age-standardised prevalence of blindness and visual impairment, yet the growth and ageing of the world's population is causing a substantial increase in number of people affected. These observations, plus a very large contribution from uncorrected presbyopia, highlight the need to scale up vision impairment alleviation efforts at all levels., Funding: Brien Holden Vision Institute., (Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
Published: 2017
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