Millions of people living with uncorrected refractive error, global study finds

Millions of people across the world lack access to basic eye care including spectacles, according to the results of a new study published in The Lancet Global Health.

Led by Anglia Ruskin University’s Professor Rupert Bourne, researchers analysed data from 815,273 participants in 76 countries and reported global refractive correction (eREC) at 65.8%, only six percentage points higher than in was in 2010.

Researchers measured both the global availability and quality of treatment for uncorrected refractive error, which they highlighted as one of the most common forms of vision loss.

The researchers pointed out that, according to this study’s findings, the goal set for by the World Health Organisation (WHO) in 2021 for eREC to increase by 40 percentage points by 2030 is likely to be missed “unless urgent action is taken across the world to increase access to basic treatments such as spectacles.”

Researchers grouped their results into ‘super regions,’ which included north Africa and the Middle East; Sub-Saharan Africa; Latin America and the Caribbean; south Asia; southeast Asia, east Asia and Oceania; central Europe, eastern Europe and central Asia, and high income, such as areas of north America and western Europe, including the UK.

They highlighted that the burden of uncorrected vision loss is found largely in low-income countries, mostly affecting women and older adults. Researchers reported that in the high-income regions, eREC is at 85% for men and 83% for women, while in sub-Saharan Africa, this compares to an estimated 30% for men and 27% for women.

The 2021 WHO targets were set at country level, with high income countries, such as the UK, expected to reach 100 percentage points eREC by 2030.

The research highlights examples of action that some countries have taken to increase eREC, which could be adopted more widely. In France, for example, full reimbursement of the cost of spectacles was introduced as part of universal health insurance in 2021–22. In Pakistan a series of national eye care plans have been implemented over the past 20 years that have increased spectacle use and reduced vision impairment caused by uncorrected refractive error.

Bourne, Professor of Ophthalmology at Anglia Ruskin University and principal investigator at the Vision Loss Expert Group, which performed the study, said: “Correction of refractive error is the safest, most efficient, and most economical intervention to improve daily vision quality for the majority of individuals affected by vision impairment worldwide, contributing to reducing poverty and improvements in wellbeing, work productivity, education, and equity.”

He added: “Data from 815,000 people across 76 countries in our new study shows that we are off track to meet World Health Organisation targets. Urgent global action is needed to reach the goal of a 40% increase in eyeglasses coverage by 2030.”