July 06, 2017
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Industry struggling to meet WHO goal for avoidable visual impairment

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Serge Resnikoff
Serge Resnikoff

The World Health Organization has set a global target for reducing the prevalence of avoidable vision impairment by 25%, using 2010 as the baseline, but the current trend would result in only an 11% reduction, according to Serge Resnikoff, MD, PhD.

Resnikoff, a senior advisor at Brien Holden Vision Institute and former head of the Program for the Prevention of Blindness and Deafness at WHO, spoke at the Prevent Blindness Focus on Eye Health National Summit.

“WHO is not defining what avoidable visual impairment is, but when you start crunching the numbers you find that what they are using as a surrogate is the combination of cataract and uncorrected refractive error (UCRE),” he said, leaving out glaucoma, diabetic macular edema and Trachoma.

The industry needs to double the reduction rate to meet the WHO goal, Resnikoff said, and should concentrate on underserved populations.

UCRE represents more than 100 million people in the world, primarily in the category of moderate-to-severe, he said.

Also, near vision impairment has not been properly studied, according to Resnikoff.

“There is a classification issue – near vision is not part of the definitions being used in the International Classifications of Diseases,” he said. “It is completely falling into the cracks and needs to be addressed.”

The combination of near and distance vision impairment equates to about 1.2 billion people who simply need a pair of glasses, Resnikoff said.

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“That should be the easiest part of our job to take care of,” he said, noting that a significant number of people with UCRE live in North America and Western Europe.

Meeting the WHO target would require a massive scale-up focused on the underserved population and the myopia epidemic, he said.

Resnikoff said that the prevalence of blindness, defined as less than 20/400 vision, has declined 36% per million from 1990 to 2010.

“It is a fantastic achievement,” he said.

“At the same time, the number of people blind in the world has only slightly declined and is around 32 million people,” Resnikoff continued.

In the moderate-to-severe visual impairment category, defined as 20/70 to 20/400, a similar trend exists, he said, explaining that the reduction in prevalence is 29% while the actual number of people with this type of impairment has increased as the global population has grown.

Overall, he thinks these statistics are positive.

“At the same time, there has been a reduction in the last 20 years in terms of people being blind because of Trachoma and cataract, while the relative importance of diabetic macular edema, glaucoma, macular degeneration and UCRE increased,” Resnikoff said. “The size of the pie has decreased, as there are fewer people visually impaired in terms of prevalence. It’s the combination of the two that you need to examine when looking at global trends.” – by Abigail Sutton

Reference:

Resnikoff S. Global public health crisis: What’s in sight? Presented at: Prevent Blindness Focus on Eye Health National Summit; Washington; June 28, 2017.

Disclosure: Resnikoff is senior advisor at the Brien Holden Vision Institute, former head of the Blindness Prevention Unit at the World Health Organization, a visiting professor at University of New South Wales and a faculty member at the University of Geneva, Switzerland, and the Universities of Lyon and Paris.