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Home About Us Global Eye Care Needs
Global Eye Care Needs PDF Print

There is an explosion in the need for eye care worldwide, with over three billion people in the world needing spectacles [ICEE data 2002].

The Situation

This figure is growing rapidly, driven by:

  • A massive growth in the number of people with myopia due to increased urbanisation and text- and screen-based activity (near work). For example, in Singapore a series of studies has shown an increase in myopia in males aged 15-25, from 26% of this group in the late 1970s, to 83% in the late 1990s [Wu 2001, Au Eong 1993, Chew 1988]. It is estimated that the number of myopes worldwide will grow from the current figure of 1.6 billion to 2.5 billion by 2020 [ICEE data 2002].jen_computerwork
  • An ageing population means that presbyopia (an age-related difficulty of focusing on near objects) will soon affect over 40% of the world’s population. A recent study has put the number of presbyopes at 1.04 billion – estimated to grow to 1.4 billion by 2020 [Holden et al. 2008].
  • In 2010, it is expected that 9.9 million Australians or 44% of the population will be over the age of 45. [Australian Bureau of Statistics, 2002].

We are now seeing a greater recognition of the importance of eye care in developing countries and of vision care delivery as a vital component of total health care.

  • Globally, there were 158 million people with significant vision impairment (< 6/18 in the better eye) as a result of uncorrected refractive error [Resnikoff et al 2008; Smith et al, 2009]. This figure includes at least eight million people with blindness (< 3/60 in the better eye) due to uncorrected refractive errors. In addition, there are an estimated 517 million people without adequate correction for functional presbyopia, making a total of 670 million suffering from unnecessary blindness and vision impairment [Holden et al. 2008].
  • Typically in the developed world people with refractive errors such as myopia and presbyopia will receive appropriate vision correction. However, in many areas in the developing world basic eye care services do not exist. A simple eye examination and the appropriate pair of glasses would restore good vision to 670 million.
  • Uncorrected refractive error is one of six priority areas in eye care identified by the World Health Organisation (WHO). Urgent international efforts by groups such as the WHO are bringing eye care to the attention of government and are supporting the growth of eye care in areas of need.
  • More than 161 million people are blind or vision impaired because of eye disease such as cataract, glaucoma and age-related macular degeneration [WHO fact sheet 2002].
  • The Western Pacific region, which includes China, Vietnam and Australia, has the highest estimated number of cases of Uncorrected Refractive Error at 62 million. The South East Asia region, encompassing Bangladesh, India and Nepal, has 49 million cases. [Smith et al. 2009].

The Costs

Almost 50% of blindness and 70% of vision impairment in Australia is caused by conditions that are preventable or treatable. Unnecessary blindness and vision impairment have significant costs to Australia, including a direct cost to government for eye care and rehabilitation services in excess of $1.8 billion per year and substantial indirect costs to individuals and the community [Taylor et al. 2006].

Examples of direct and indirect costs include:

  • Government: increased costs on the health system (for example, vision loss substantially increases the risk of motor vehicle accidents, falls and hip fractures in the elderly, and depression); early entry into supported accommodation, such as nursing homes and aged-care hostels; early reliance on social welfare system (through loss of income and reduced productivity).
  • Community: increased pressure on community services; loss of the participation of a valuable member of the community; increased road safety issues.
  • Individual: limited education and employability; increased mortality (risk of death is doubled) and morbidity; creation of other health issues (physical and emotional, e.g. depression which is 3 times more likely); diminished quality of life through reduced independence, mobility and confidence.
  • National: restricted economic and social development; lost opportunities in innovation and growth.

A Good Investment Opportunity

The 158 million people with vision impairment from uncorrected refractive error are, on average, less productive than they would be if they had glasses to give them normal vision. The estimated annual global economic productivity loss due to vision impairment from uncorrected refractive error is $269 billion [Smith et al. 2009].

  • The vision impairment and lost productivity exist due to lack of trained personnel, infrastructure, eye health awareness and optical supplies.publichealth_istock
  • It is estimated that a long-term sustainable solution, based on the need for glasses to be replaced every three years, would cost in the vicinity of $26 billion [Smith et al. 2009].
  • This means that the cost to fix the problem is around one tenth of the annual productivity loss that will continue until the problem is fixed. Or another way to look at it is that, based on this published evidence, an investment of $26 billion to fix the problem would repay the world economy at a rate of 1000% per annum. That would be money well spent.

 

References

  1. Au Eong KG, Tay TH, Lim MK, ‘Race, culture and myopia in 110, 236 young Singaporean males’, Singapore Med J 1993; Vol 34: 29-32.
  2. Au Eong KG, Tay TH, Lim MK, ‘Education and myopia in 110,236 young Singaporean males’, Singapore Med J 1993; Vol 34: 489-492.
  3. Chew SJ, Chia SC, Lee LKH, ‘The pattern of myopia in young Singaporean men’, Sing Med J 1988; 29:201-211.
  4. Holden BA, Fricke TR, May Ho S, Wong R, Schlenther G, Cronje S, Burnett A, Papas E, Naidoo KS, Frick KD, ‘Global vision impairment due to uncorrected presbyopia’, Archives of Ophthalmology, Vol 126 (No. 12), Dec 2008.
  5. International Centre for Eyecare Education data, 2002.
  6. National Health Survey 2001: summary of results. Canberra: Australian Bureau of Statistics, 2002.
  7. Resnikoff S, Pascolinin D, Mariotti SP, Pokharel GP, 'Global magnitude of visual impairment ciaused by uncorreceted refractive errors in 2004', Bulletin of the World Health Organization, January 2008, 86(1).
  8. Smith TST, Frick KD, Holden BA, Fricke TR, Naidoo KS, ‘Potential lost productivity resulting from the global burden of uncorrected refractive error’ in Bulletin of the World Health Organisation, 2009; 87.
  9. Taylor HR, Pezzullo ML, Keeffe JE, 'The economic impact and cost of visual impairment in Australia', Br J Ophthalmol. 2006 March; 90(3): 272–275. doi: 10.1136/bjo.2005.080986.
  10. World Health Organization News Releases 2006: (http://www.who.int/mediacentre/news/releases/2006/pr55/en/print.html).
  11. World Health Organization Fact Sheet 2002: (http://www.who.int/mediacentre/factsheets/fs282/en/).
  12. Wu HM, Seet B, Yat EPH, Saw SM, Lim TH, Chia KS, ‘Does education explain ethnic differences in myopia prevalence? A population-based study of young adult males in Singapore’, Optom Vis Sci, Vol 78, No. 4, pp. 234-239.