Vision & Eye Research Unit, Anglia Ruskin University, Cambridge, UK.
Department of Statistics, University of Oxford, Oxford, UK.
Lancet Glob Health. 2017 Sep;5(9):e888-e897. doi: 10.1016/S2214-109X(17)30293-0. Epub 2017 Aug 2.
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.
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).
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.
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.
Brien Holden Vision Institute.
全球和区域盲症及视力损伤的流行率估计数对于公共卫生政策的制定非常重要。本研究旨在提供全球盲症和视力损伤的流行率估计数、趋势和预测数据。
我们对 1980 年至 2015 年期间发表的与全球视力损伤和盲症相关的基于人群的数据集进行了系统性综述和荟萃分析。我们采用分层模型来估计 2015 年全球轻中度视力损伤（矫正视力在 6/12 到 6/18 之间）、中重度视力损伤（矫正视力在 6/18 到 3/60 之间）、盲症（矫正视力在 3/60 以下）和功能性老视（定义为在最佳矫正远视力优于 6/12 时，40 cm 近视力差于 N6 或 N8）的流行率（按年龄、国家和性别划分）。
2015 年，全球 73.3 亿人口中，估计有 3600 万人（80%置信区间 [80%UI] 1290 万至 6540 万）患有盲症（粗患病率为 0.48%；80%UI 0.17-0.87；女性占 56%），2.166 亿人（80%UI 9850 万至 3591 万）患有中重度视力损伤（2.95%；80%UI 1.34-4.89；女性占 55%），1.885 亿人（80%UI 6450 万至 3502 万）患有轻度视力损伤（2.57%；80%UI 0.88-4.77；女性占 54%）。功能性老视影响了估计 10.947 亿（80%UI 5811 万至 16865 万）35 岁及以上人群，其中 6.667 亿（80%UI 3649 万至 9976 万）为 50 岁及以上人群。盲症人数增加了 17.6%，从 1990 年的 3060 万（80%UI 990 万至 5730 万）增加到 2015 年的 3600 万（80%UI 1290 万至 6540 万）。这种变化归因于三个因素，即人口增长（38.4%）、人口增长后人口老龄化（34.6%）以及年龄别流行率降低（-36.7%）。中重度视力损伤人数也从 1990 年的 1.599 亿（80%UI 6830 万至 2.700 亿）增加到 2015 年的 2.166 亿（80%UI 9850 万至 3591 万）。
全球盲症和视力损伤的年龄标准化流行率正在持续下降，但世界人口的增长和老龄化导致受影响人数大幅增加。这些观察结果，加上未矫正老视的巨大贡献，突显了在各个层面加大视力损伤缓解力度的必要性。
Brien Holden 视觉研究所。
