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A conversation with leading epidemiologists about the status of vision loss in the seven super-regions of the world.
In this article we speak with Vision Loss Expert (VLEG) members Professors Mukharram M. Bikbov and Tunde Peto about the status of vision loss in the Central Eastern Europe and Central Asia Region.
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Our results show that uncorrected visual acuity was the most frequent cause of reversible visual impairment, while age-related macular degeneration, glaucoma and diabetic retinopathy were most commonly responsible for irreversible vision impairment. The most common cause for blindness was glaucoma.
Key message 1: Provision of affordable glasses for those requiring it will have a major societal impact, including educational attainment in the young and increased productivity in those in working age and /or with presbyopia.
Key message 2: In order to minimize the impact of the causes of irreversible visual loss and blindness, appropriate clinical pathways with well trained healthcare professionals and affordable treatment will need to be in place.
Key message 3: Promoting healthy lifestyle among citizens for the whole lifecourse from birth to death is essential to enable healthy ageing which will minimize the risk of losing sight.
Forecasting to the next 30 years, the number of blind individuals are expected to increase, particularly in Eastern Europe and as such, prevention is the essential public health issue, this is our first key message.
Key message 2: Provision of appropriate training and education not only to healthcare workers but also to patients about eye-health is vital so all are aware of the importance of early detection and timely treatment.
Key message 3: Emerging problems, such as short-sightedness in childhood will have a major impact in the future and has to be invested in now to prevent major impact in the future.
Between 1990-2010, the age-standardized prevalence of visual impairment and blindness reduced the most. We may assume it occurred due to organization of high-quality ophthalmological care in the region including professional development and training of specialists, development of diagnostic and surgical equipment.
Sadly, this kind of information can only be inferred but not proven by our data-sets. Unfortunately, although ophthalmology has become the busiest sub-speciality, there is still not enough attention on policy-makers levels to ophthalmology. The primary aim for all services should be providing equitable access to eye care for all citizens.
The high prevalence of myopia as a cause of visual impairment among the population was a bit of a surprise. This finding confirms the importance of monitoring and studying myopia as a potentially blinding disease and conducting further regional studies to understand this result better. It also demonstrates a weakness of the previous meta-analyses in which myopic maculopathy had often not explicitly been presented as a separate cause for vision impairment.
This data is informative to fight for further attention for the prevention and care of vision and eye diseases. These estimates can help better assess the extent of potential vision problems at the local level and guide the development risk reduction programmes so the prevalence of diseases leading to blindness and visual impairment can be reduced. We hope this study will inform new interventions for the prevention and care of vision and eye problems.
The health consequences associated with vision loss go beyond the visual system. The economic implications of vision loss entail costs that affect national health care expenditures, but also the associated costs of people. Therefore, public health approaches to improving eye and vision health should focus on costs to ensure equity among the population groups susceptible to visual impairment and we must ensure that preserving vision is part of the healthy ageing programmes.
Population based studies might wish to include various environmental factors so their influence eye and vision health, especially in the currently under-represented groups, such as children and very old adults, can be studied.
Image on top: Spectacled child with an open book/ Юлия Белякова