The Lancet Global Health Commission on Global Eye Health [1] highlights the changing nature of the issues facing eye health professionals worldwide. Over the past 20 years there have been major improvements in prevention of blindness from infectious diseases such as onchocerciasis and trachoma. However, with an increasing ageing population, chronic eye diseases such as diabetic retinopathy, glaucoma and age-related macular degeneration are becoming more of a problem. The Lancet Commission Report highlights how this requires a refocused public health and clinical response and recommends that eye health be reframed as a development issue. 

The Lancet Commission is the culmination of two years’ work by 73 multidisciplinary experts from 25 countries and brings together new and existing research in eye health, epidemiology and economics. The Commission was co-chaired by Matthew Burton, Director of the International Centre for Eye Health at the London School of Hygiene & Tropical Medicine (LSHTM), and Hannah Faal, Professor of International Eye Health at the University of Calabar, Nigeria.  

A billion people are currently living with vision loss that could be prevented or treated with existing cost-effective interventions. Latest estimates show that 1.8 billion people are expected to be living with untreated vision loss by 2050 unless there is significant urgent investment and a coordinated response. The vast majority90% - live in low- and middle-income countries (LMICs). There is also gender inequality: 55% of people living with vision loss in LMICs are women and girls. 

The shortage of eye health professionals is a barrier in LMICs, with one ophthalmologist per million people in parts of sub-Saharan Africa, compared with an average of 76 ophthalmologists per million people in high-income countries.  

The Commission authors show multiple links between good eye health and the achievement of the 2030 Sustainable Development Goals (SDGs), highlighting improvements in gender equality, education, employment prospects, work productivity, household income and economic productivity. 

The Report clearly shows that improving eye health directly benefits the economic and social prosperity of individuals and countries. The Commission investigated loss in productivity caused by vision impairment in people of working age and found that the economic cost of blindness and moderate to severe vision loss was 411 billion USD in 2020 

The Commission makes several calls to action for governments, including making eye health a key component of universal health coverage, eliminating cost barriers and improving access to quality eye care, particularly in remote areas. This requires inclusion in national health policies, national plans and service delivery at every level of the health system.   

Professor Matthew Burton said: “The Commission has built a compelling case for global action on blindness. The provision of eye health services is associated with increased income and economic prosperity, better educational outcomes and reduced inequalities. It is unacceptable that more than a billion people worldwide are needlessly living with treatable vision impairment.”

  1. MJ Burton et al.The Lancet Global Health Commission on Global Eye Health: vision beyond 2020. The Lancet Global Health 2021; DOI: 10.1016/S2214-109X(20)30488-5. 
Covadonga Bascaran

VISION 2020 LINKS Programme, International Centre for Eye Health, LSHTM, Keppel Street, London, WC1E 7HT, UK.

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