Understanding eye care needs beyond vision loss across six countries: addressing distance and near visual impairment and other eye conditions
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Objective
Population growth and ageing are placing increasing pressure on eye care services. We present a model estimating comprehensive eye care needs using data across six countries.
Methods and analysis
We used cross-sectional data from community screening programmes (n = 2,338,193; all ages) conducted in 2022–2023 in India, Pakistan and Nepal (South Asia) and Kenya, Tanzania and Uganda (sub-Saharan Africa). Total eye care need was defined as the presence of distance visual impairment (VI), near VI, or any other eye condition requiring care in at least one eye, reported with 95% confidence intervals (CI). Distance and near VI were assessed on presenting visual acuity, measured with existing correction where available; estimates therefore reflect unmet need rather than total impairment. Logistic regression identified factors associated with increased need, reported as adjusted odds ratios (AORs).
Results
Among those aged ≥50 years, the prevalence of distance VI was 36.3% (95% CI: 36.1– 36.5), and 74.8% (95% CI: 74.6–74.9) had at least one eye care need. In those aged <50 years, the prevalence of distance VI was 6.3% (95% CI: 6.2–6.3), and 19.9% (95% CI: 19.8–19.9) had at least one eye care need. Higher need was observed among older individuals (AOR: 1.06 per year), females (AOR: 1.13), and in programmes conducted in sub-Saharan Africa compared to South Asia (AOR: 2.75); all p-values < 0.001.
Conclusion
This study expands knowledge by including all age groups, all types of eye care needs, and each affected eye, not only bilateral problems, offering a more complete picture of eye care needs in mass screening programmes.
What is already known on this topic
Most eye care survey data before 2024 focus on distance visual impairment and its causes in people aged 50+. Near vision impairment and other eye conditions are often excluded from population surveys due to feasibility constraints.
What this study adds
As a result, current estimates likely underestimate the true burden of eye care needs. Analysis of >2.3 million people screened in six countries provides a more comprehensive estimate of population eye care needs.
How this study might affect research, practice or policy
These results highlight the importance of planning services for a wider range of eye care needs, including near vision correction and other conditions. In addition, this study demonstrates the potential of large-scale digital programme data to inform population eye health monitoring and service planning.
