The researchers believed that the escalating prevalence of cataracts, diabetic retinopathy, near vision loss and age-related macular degeneration might be attributed to the aging of the working-age population. Photo: Christine Sindt, OD. Click image to enlarge.

Because of its association with general health and employment prospects, visual impairment in working-age individuals has steadily become a major public health concern. Researchers based in China investigated the trends of visual impairment prevalence and disability-adjusted life-years in working-age individuals between ages of 18 and 64 from 204 countries and territories from 1990 to 2019. Their study, published last week in JAMA Ophthalmology, indicated that the global burden of visual impairment among working-age individuals has been progressively increasing over the past three decades and is anticipated to persistently grow in the foreseeable future. While there was a mild decrease in visual impairment prevalence rates in less-developed countries, their findings suggest that the number of prevalent cases globally has increased substantially.

This cross-sectional, population-based study used data from the Global Burden of Disease 2019 study. Visual impairment was defined as visual acuity of less than 20/60 or near visual acuity of less than 20/40 distance equivalent as determined by Snellen chart.

There were 437,539,484 cases of visual impairment globally in 2019, representing a 91.5% increase in cases since 1990 and resulting in 12,563,276 disability-adjusted life-years. The burden increased in countries with a high and high-middle sociodemographic index, and the highest burden was seen in countries with a low sociodemographic index. This increase in the burden of visual impairment was observed in all age groups. Regionally, the greatest increase in prevalence was observed in Eastern Europe. Among all countries and territories, Nepal had the highest national prevalence of visual impairment per 100,000 population in 2019, while South Sudan had the highest disability-adjusted life years rate per 100,000 population.

Regarding the high- and high-middle-socioeconomic index groups, the researchers noted that the escalating prevalence of cataracts, diabetic retinopathy, near vision loss and age-related macular degeneration might be attributed to the aging of the working-age population. With the continuing aging of the population globally, they expect this issue to worsen in the future.

“This study offers valuable insights into the disease burden in this population in various regions and countries with diverse development levels and could assist policy makers and clinicians in formulating suitable strategies for visual impairment prevention and treatment,” the authors wrote in their paper. “These strategies should aim at alleviating the health hazards associated with visual impairment among working-age individuals, which may have substantial outcomes with regard to personal well-being and socioeconomic productivity.”