Eye care, vision impairment and blindness
Eye conditions are remarkably common. Those who live long enough will experience at least one eye condition during their lifetime.
Globally, at least 1 billion people have a near or distance vision impairment that could have been prevented or has yet to be addressed. In the absence of timely detection, reduced or absent eyesight can have long-term personal and economic effects. Vision impairment affects people of all ages, with the majority being over the age of 50. Young children with early onset severe vision impairment can experience lower levels of educational achievement, and in adults it often affects quality of life through lower productivity, decreased workforce participation and high rates of depression.
Vision impairment and blindness impact the life of people everywhere. In low- and middle-income settings the burden of vision impairment can be even greater due to fewer opportunities to access the most essential eye care services.
Cataracts and uncorrected refractive errors are estimated to be the leading causes of vision impairment; however, other causes for vision impairment cannot be ignored. Age-related macular degeneration, glaucoma, long standing systemic conditions like diabetes causing diabetic retinopathy, infectious diseases of the eye and trauma to the eye are all equally important causes for vision impairment that need to be addressed.
Eye conditions that can be targeted effectively with preventive strategies include congenital and acquired eye conditions, myopia, ocular trauma, and ocular infections and inflammations. A good example of this is the practice of preventative lifestyle changes among children, including a combination of increased time spent outdoors and decreased near-work activities. This may delay the onset and slow the progression of myopia, which reduces the risk of high myopia and its complications later in life.
Importantly, the prevention and management of systemic diseases, such as diabetes and hypertension, can also be effective in reducing the risk of ocular diseases. In addition, interventions to prevent vitamin A deficiency, measles and rubella, through vitamin A supplementation and immunization, are highly effective in reducing the risk of corneal opacities that can occur secondary to these conditions.
Another example is the prevention of workplace ocular injuries through promoting the use of protective eye equipment (e.g., masks, protective goggles, visors etc.) during high-risk activities and industries (e.g., certain sports, agricultural activities, construction workers, welders etc.).
Although effective interventions exist to address the two leading causes of vision impairment, namely optical correction for refractive errors and surgery for cataract, there remains a large unmet need for care. Spectacles are the most common intervention used worldwide to compensate for refractive error, as well as contact lenses and refractive surgeries. Spectacles and cataract surgery are both highly cost-effective interventions that can substantially improve a person’s quality of life.
Treatment and care for many eye conditions, such as glaucoma, diabetic retinopathy, pterygium, amblyopia, strabismus and retinopathy of prematurity require long-term monitoring to control the progression of the condition. Treatment is also required for commonly presenting acute eye conditions that do not typically cause vision impairment but affect people’s lives with pain and discomfort (dry eye, conjunctivitis and blepharitis, etc.). To prevent further complications, the management of these eye conditions is often directed at treating the cause or alleviating the symptoms.
Vision impairment that cannot be corrected or reversed requires rehabilitation measures, for which there are several available. For those who live with blindness, braille reading, counselling and home skills training, mobility training with white canes and digital assistive technologies can ensure free, independent and safe mobility.
