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Abstract #18938 Published in IGR 3-1
World blindness: a 21st century perspective
Taylor HR; Keeffe JEBulletin de la Société Belge d'Ophtalmologie 2001; 85: 261-266
This interesting article on world blindness considers a vision for the year 2020, and thus mentions major epidemiological studies on glaucoma and the chances for glaucoma screening. Other diseases are refractive errors, cataract, diabetic retinopathy, and age-related macular degeneration. The World Health Organization and the International Agency for the Prevention of Blindness have developed a global initiative for the elimination of avoidable blindness by the year 2020. Information on this initiative is available on www.2020.org. The authors describe the causes of blindness in the world, of which 90% occurs in developing countries. Surprisingly, a refractive error is responsible for one out of every four causes of blindness and half of those with low vision. Even in Australia, refractive error counted for 24% of legal blindness. As far as glaucoma is concerned, nowadays we have a better idea of the disease and certainly better therapeutic modalities. The major problem with glaucoma is that at least half the people suffering from it are not diagnosed and are not receiving treatment. The challenge is to identify these people. These authors describe that one person in ten will eventually develop glaucoma. In the last years, a genetic basis for at least some cases of glaucoma has been established. Family history of glaucoma is important. The authors discuss the challenge of glaucoma screening and are hopeful with regard to new psychophysical methods and imaging systems. They do not discuss the question of whether indeed we need to find the earliest stages of glaucoma, or whether we should limit ourselves to discovering well-established glaucoma cases. The authors conclude with the following: in developed countries, blindness and vision loss increase three-fold for each decade over 40. This means that the number of people who are vision-impaired or blind will double over the next 20 years, just as an effect of the aging of our population. Similarly, the need for cataract surgery, as well as the number of people needing screening or treatment for diabetic eye disease. This will need both an increased allocation of resources and the more efficient use of the resources we have at present. The challenge in the years ahead will be to find ways to prevent, delay, or treat diseases such as glaucoma and macular degeneration, diseases that seem to result from our living longer than our eyes. Vision 2020, the global elimination of avoidable blindness around the world, clearly has significant implications for us in developed countries where much still needs to be done, in addition to the more obvious issues in developing areas.
Dr H.R. Taylor, Centre for Eye Research Australia, University of Melbourne, 32 Gisborne Street, East Melbourne, VIC 3002, Australia. htaylor@unimelb.edu.au
Classification:
1.5 Glaucomas as cause of blindness (Part of: 1 General aspects)
