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[Editorial] A vision for universal eye health

Tags: General

World Sight Day, Oct 10, 2019, opened the final stages of Vision2020 and the Global Action Plan, two global advocacy initiatives that strived to tackle the global burden of avoidable blindness and vision impairment. 80% of vision impairment is preventable or treatable, yet it affects millions of people, and many have no access to affordable, good-quality eye care. WHO's first World Report on Vision, released on Oct 8, 2019, suggests how to meet the world's growing eye care needs.

Common causes of vision impairment (near-vision loss, refraction disorders, and cataracts) are among the top-25 causes of years lived with disability. The International Agency for the Prevention of Blindness estimates that 36 million people are blind and 217 million people are vision impaired, and the burden is borne disproportionately by low-income and middle-income countries (LMICs). Importantly, at least 1 billion people have vision impairment that could have been prevented or has yet to be addressed. In this light, WHO calls for eye care to become an integral part of universal health coverage.

The success of universal eye care will hinge on bridging the gap between aspiration and effective care delivery. Cataract and refractive error are the leading causes of blindness and vision impairment, and although both have effective interventions (eg, a simple pair of reading spectacles for refractive error), understanding how to improve access to these interventions for everyone, everywhere, is insufficient. Likewise, ensuring quality of care for all remains challenging. For example, cataract surgery is cost-effective and usually restores sight, but many people are still severely vision impaired or blind after poor-quality surgery. Good evidence on how to improve quality of care in LMICs is also scarce.

Taking on the next phase of global advocacy, the Lancet Global Health Commission on Global Eye Health will seek solutions to provide equity in access, quality, and effective implementation of eye health services. Sight is precious. Fully accessible and affordable evidence-based strategies that are integrated into health systems and delivered at high quality should ensure that nobody loses their vision unnecessarily.
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