Globally, the prevalence of blindness and vision loss among children and adolescents has been declining since 1990, according to research published in Ophthalmology. However, participants’ age, vision impairment type, and sociodemographic index of their country of residence creates some variability in these findings, the report shows.
Investigators sourced study data from the Global Burden of Diseases, Injuries, and Risk Factors Study, a database that includes blindness and vision loss information from 204 countries, and evaluated trends among children and adolescents (age range, 0-19 years). The team defined blindness as visual acuity (VA) worse than 3/60 (Snellen) or less than 10% visual field around central fixation, severe vision loss as VA better than 3/60 but worse than 6/60, moderate vision loss as VA better than 6/60 and worse than 6/18, and near-vision loss as VA worse than 6/12.
Worldwide prevalence of blindness and vision loss was 1091.4 per 100,000 in 1990, which was reduced to 1036.9 per 100,000 in 2019, the report shows. This finding shows an average annual percentage change (AAPC) of -0.2 (95% CI, -0.3 to -0.2; P <.001) during the 30-year period. Similarly, the years lived with disability (YLD) rates due to blindness or vision loss decreased from 44.5 per 100,000 in 1990 to 40.2 per 100,000 in 2019 (AAPC, -0.4; 95% CI, -0.5 to -0.4; P <.001).
Blindness and vision loss declined most among children younger than 5 years (AAPC, -0.4; P <.001), and individuals with low to middle sociodemographic index (AAPC, -0.4; P <.001). Participants with a middle sociodemographic index (P =.42) and individuals who lived in Australasia (P =.173), Eastern Sub-Saharan Africa (P =.139), or Tropical Latin America (P =.15) did not experience decreasing trends during the study duration. Individuals from East Asia (AAPC, 0.4; P <.001), high-income North American nations (AAPC, 0.3; P <.001), and Oceana (AAPC, 0.01; P <.001) experienced significant increases in blindness and vision loss, according to the report.
The YLD associated with blindness and vision loss experienced the greatest decline among boys and men (AAPC, -0.5; P <.001), but no change was observed among those living in Australasia (P =.338) or East Asia (P =.356).
Global refractive disorder, near vision loss, and other vision loss prevalence (AAPC, -0.2; P <.001) and associated YLDs (AAPC, -0.2; P <.001) decreased, the report shows.
“Over the past three decades, cumulative global efforts have significantly decreased the burden of blindness and vision loss among children and adolescents,” according to the study authors. “However, increases in the burden of near vision loss merit attention. Future efforts to alleviate blindness and vision loss in this population (0–19 years of age) involve targeting specific kinds of impairment, age groups, and countries.”
Study limitations include failure to determine factors causing blindness and vision loss trend changes and failure to identify specific eye diseases.
Liu L, Jiao J, Yang X, et al. Global, regional, and national burdens of blindness and vision loss in children and adolescents from 1990 to 2019: a trend analysis. Ophthalmol. Published online February 7, 2023. doi:10.1016/j.ophtha.2023.02.002