	Measure	Preschool children (1–4 years old)	School children (5–9 years old)	Teenagers (10–14 years old)
Distance and/or near vision impairment	DALY number	318757.05 (95%UI: 193553.57–489003.16)	564216.66 (95% UI: 334649.86–901892.63)	589929.34 (95% UI: 367714.79–933286.33)
	DALY rate (per 100,000)	58.73 (95%UI: 35.66–90.10)	85.33 (95% UI: 50.61–136.40)	92.72 (95% UI: 57.79–146.68)
Refractive errors	DALY number	273134.25 (95%UI: 163792.38–422163.01)	470756.62 (95% UI: 278775.93–749153.61)	456770.93 (95% UI: 281034.12–724995.69)
	DALY rate (per 100,000)	50.33 (95%UI: 30.18–77.79)	71.20 (95% UI: 42.16–113.30)	71.79 (95% UI: 44.17–113.95)
Near vision impairment	DALY number	18171.59 (95%UI: 8360.55–34059.99)	55924.87 (95% UI: 25431.04–104611.53)	88984.88 (95% UI: 41076.85–166691.91)
	DALY rate (per 100,000)	3.35 (95% UI: 1.54–6.28)	8.46 (95% UI: 3.85–15.82)	13.99 (95% UI: 6.46–26.20)
Other vision impairment	DALY number	27451.21 (95UI: 17056.12–40600.11)	37535.16 (95% UI: 22938.79–58436.59)	44173.54 (95% UI: 27747.10–67319.24)
	DALY rate (per 100,000)	5.06 (95% UI: 3.14–7.48)	5.68 (95% UI: 3.47–8.84)	6.94 (95% UI: 4.36–10.58)

Measure

Preschool children (1–4 years old)

School children (5–9 years old)

Teenagers (10–14 years old)

Distance and/or near vision impairment

DALY number

318757.05 (95%UI:

193553.57–489003.16)

564216.66

(95% UI:

334649.86–901892.63)

589929.34

(95% UI:

367714.79–933286.33)

DALY rate (per 100,000)

58.73

(95%UI: 35.66–90.10)

85.33

(95% UI: 50.61–136.40)

92.72

(95% UI: 57.79–146.68)

Refractive errors

DALY number

273134.25 (95%UI:

163792.38–422163.01)

470756.62

(95% UI:

278775.93–749153.61)

456770.93

(95% UI:

281034.12–724995.69)

DALY rate (per 100,000)

50.33

(95%UI: 30.18–77.79)

71.20

(95% UI: 42.16–113.30)

71.79

(95% UI: 44.17–113.95)

Near vision impairment

DALY number

18171.59

(95%UI: 8360.55–34059.99)

55924.87

(95% UI:

25431.04–104611.53)

88984.88

(95% UI:

41076.85–166691.91)

DALY rate (per 100,000)

3.35

(95% UI: 1.54–6.28)

8.46

(95% UI: 3.85–15.82)

13.99

(95% UI: 6.46–26.20)

Other vision impairment

DALY number

27451.21

(95UI: 17056.12–40600.11)

37535.16

(95% UI:

22938.79–58436.59)

44173.54

(95% UI:

27747.10–67319.24)

DALY rate (per 100,000)

5.06

(95% UI: 3.14–7.48)

5.68

(95% UI: 3.47–8.84)

6.94

(95% UI: 4.36–10.58)

Table 1. Global health burden of paediatric vision impairment in three paediatric age groups in 2017.

95% UI 95% uncertainty interval.

	Age groups	HDI		Inequality-adjusted HDI		SDI		GDP per capita		Number of physicians
	Age groups	Correlation coefficient	p-Value	Correlation coefficient	p-Value	Correlation coefficient	p-Value	Correlation coefficient	p-Value	Correlation coefficient	p-Value
Distance and/or near vision impairment	1–4 years old	0.17	0.023	0.21	0.010	0.16	0.031	0.03	0.697	0.18	0.018
	5–9 years old	0.09	0.241	0.12	0.164	0.08	0.293	−0.02	0.788	0.11	0.157
	10–14 years old	−0.04	0.559	−0.04	0.625	−0.06	0.466	−0.11	0.142	0.02	0.823
Refractive disorders	1–4 years old	0.26	<0.001	−0.33	<0.001	0.26	<0.001	0.09	0.225	0.25	0.001
	5–9 years old	0.25	0.001	0.31	<0.001	0.25	0.001	0.10	0.185	0.24	0.001
	10–14 years old	0.22	0.004	0.27	0.001	0.22	0.003	0.08	0.263	0.21	0.006
Near vision impairment	1–4 years old	−0.66	<0.001	−0.82	<0.001	−0.75	<0.001	−0.59	<0.001	−0.73	<0.001
	5–9 years old	−0.66	<0.001	−0.82	<0.001	−0.75	<0.001	−0.59	<0.001	−0.73	<0.001
	10–14 years old	−0.66	<0.001	−0.82	<0.001	−0.75	<0.001	−0.59	<0.001	−0.73	<0.001
Other causes of vision impairment	1–4 years old	−0.06	0.411	−0.11	0.180	−0.03	0.696	−0.01	0.938	−0.03	0.660
	5–9 years old	−0.16	0.037	−0.25	0.002	−0.17	0.020	−0.08	0.295	−0.18	0.018
	10–14 years old	−0.21	0.006	−0.32	<0.001	−0.25	0.001	−0.11	0.146	−0.25	0.001

Table 2. Correlation between DALYs rate of paediatric vision impairment and socioeconomic factors in three age groups in 2017.

HDI human development index, SDI socio-demographic index, GDP gross domestic product.
Statistically significant p-values are in bold.

	Age Groups	DALY number					DALY rate
	Age Groups	1990 Thousands (95% UI)	2015 Thousands (95% UI)	% of change	Amount of change per 1 year	p-Value	1990 (95% UI)	2015 (95% UI)	% of change	Amount of change per 1 year	p-Value
Distance and/or near vision impairment	1–4 years old	336.67 (95% UI:206.96–511.32)	320.56 (95% UI:195.47–491.11)	−4.79%	−535.14 (SE:677.88)	0.474	65.79 (95% UI:40.44–99.92)	59.16 (95% UI:36.07–90.64)	−10.08%	−0.25 (SE:0.05)	0.007
	5–9 years old	550.67 (95% UI:329.69–876.39)	555.06 (95% UI:3331.06–888.22)	−0.80%	−273.31 (SE:870.81)	0.769	94.17 (95% UI:56.38–149.87)	85.26 (95% UI:50.85–136.44)	−0.46%	−0.33 (SE:0.09)	0.021
	10–14 years old	549.17 (95% UI:340.49–860.31)	580.96 (95% UI:360.30–921.32)	5.79%	741.90 (SE:800.43)	0.406	101.97 (95% UI:63.23–159.75)	92.80 (95%UI:57.55–147.17)	−8.99%	−0.35 (SE:0.10)	0.024
Refractive disorders	1–4 years old	289.66 (95% UI:175.73–440.96)	274.73 (95% UI:164.95–420.65)	−5.15%	−505.55 (SE:607.98)	0.452	56.61 (95% UI:34.34–86.17)	50.70 (95% UI:30.44–77.63)	−10.44%	−0.22 (SE:0.05)	0.009
	5–9 years old	463.23 (95% UI:274.33–732.23)	462.43 (95% UI:276.30–731.54)	−0.17%	−419.80 (SE:807.52)	0.631	79.21 (95% UI:46.91–125.23)	71.03 (95% UI:42.44–112.37)	−10.33%	−0.31 (SE:0.09)	0.023
	10-14 years old	431.72 (95% UI:265.31–680.83)	448.94 (95% UI:276.21–706.37)	4.10%	219.62 (SE:612.71)	0.738	80.17 (95% UI:49.27–126.42)	71.71 (95% UI:44.12–112.83)	−10.55%	−0.33 (SE:0.09)	0.021
Near vision impairment	1–4 years old	16.66 (95% UI:7.68–31.32)	18.40 (95% UI:8.54–34.01)	10.44%	75.24 (SE:7.55)	0.001	3.26 (95% UI:1.50–6.12)	3.40 (95% UI:1.58–6.28)	4.29%	0.01 (SE:0.00)	0.184
	5–9 years old	47.97 (95% UI:21.97–90.40)	55.40 (95% UI:25.35–104.76)	15.49%	257.42 (SE:17.52)	<0.001	8.20 (95% UI:3.76–15.46)	8.51 (95% UI:3.89–16.09)	3.78%	0.02 (SE:0.01)	0.075
	10–14 years old	71.91 (95% UI:32.66–134.59)	88.34 (95% UI:40.32–165.30)	22.85%	631.57 (SE:145.42)	0.012	13.35 (95% UI:6.06–24.99)	14.11 (95% UI:6.44–26.40)	29.85%	0.04 (SE:0.01)	0.005
Other causes of vision impairment	1–4 years old	30.35 (95% UI:19.15–44.43)	27.43 (95% UI:17.05–41.00)	−9.62%	−103.50 (SE:64.00)	0.181	5.93 (95% UI:3.74–8.68)	5.06 (95% UI:3.15–7.57)	−14.67%	−0.03 (SE:0.01)	0.003
	5–9 years old	39.46 (95% UI:24.34–59.39)	37.24 (95% UI:22.79–57.14)	−5.63%	−119.04 (SE:64.09)	0.137	6.75 (95% UI:4.16–10.16)	5.72 (95% UI:3.50–8.78)	−15.26%	−0.04 (SE:0.01)	0.005
	10–14 years old	45.53 (95% UI:29.09–68.73)	43.68 (95% UI:27.22–65.85)	−4.06%	−123.97 (SE:64.71)	0.128	8.46 (95% UI:5.40–12.76)	6.98 (95% UI:4.35–10.52)	−17.49%	−0.06 (SE:0.01)	0.003

Table 3. Global trends of vision impairment DALYs between 1990 to 2015 in three paediatric age groups.

SE standard error, UI95% uncertainty interval 95%.

Statistically significant p-values are in bold.

Flaxman SR, Bourne RRA, Resnikoff S, Ackland P, Braithwaite T, Cicinelli MV, et al. Vision loss expert group of the Global Burden of Disease Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis. Lancet Glob Health. 2017;5:e1221–e1234.
DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1859–922. 2017
Pascolini D, Mariotti SP. Global estimates of visual impairment: Br J Ophthalmol. 2012;96:614–8.
Wang W, He M, Li Z, Huang W. Epidemiological variations and trends in health burden of glaucoma Acta Ophthalmol. 2019;97:e349–e355.
He M, Wang W, Huang Variations and trends in health burden of visual impairment due to cataract: a global analysis. Invest Ophthalmol Vis Sci. 2017;58:4299–306.
Wang D, Jiang Y, He M, Scheetz J, Wang W. Disparities in the global burden of age-related macular degeneration: an analysis of trends from 1990 to Curr Eye Res. 2019;44:657–63.
Lou L, Yao C, Jin Y, Perez V, Ye J. Global patterns in health burden of uncorrected refractive Invest Ophthalmol Vis Sci. 2016;57:6271–7.
Lane M, Lane V, Abbott J, Braithwaite T, Shah P, Denniston Multiple deprivation, vision loss, and ophthalmic disease in adults: Global perspectives. Surv Ophthalmol. 2018;63:406–36.
Gilbert CE, Anderton L, Dandona L, Foster A. Prevalence of visual impairment in children: a review of available data. Oph- thalmic Epidemiol. 1999;6:73–
Gilbert C, Foster A. Childhood blindness in the context of VISION 2020 the right to sight. Bull World Health Organ. 2001;79:227–
Global Health Data Exchange. GBD Data Tool. Available at: http://ghdx.healthdata.org/gbd- results-tool. Accessed February 25,
WHO World report on vision Available at: https://www.who.int/ publications/i/item/world-report-on-vision. Accessed March 6,
Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015. GBD 2015 SDG Collaborators. Lancet. 2016;388:1813-50.
World Health Organization. Preventing blindness in children, Report of a WHO/ IAPB scientiﬁc meeting. Geneva:WHO. (WHO/PBL/00.77).
Action plan for the prevention of avoidable blindness and visual impairment 2014–2019: towards universal eye health: a global action plan 2014– Available at: http://www.who.int/ blindness/actionplan/en/index.html. Accessed March 7, 2020.
https://data.worldbank.org/indicator/. Accessed October 30,
Hong H, Mujica OJ, Anaya J, Lansingh VC, Lopez E, Silva The challenge of universal eye health in Latin America: dis- tributive inequality of ophthalmologists in 14 countries. BMJ Open. 2016;6:e12819.
Resnikoff S, Felch W, Gauthier TM, Spivey B. The number of ophthalmologists in practice and training worldwide: a growing gap despite more than 200,000 practitioners. Br J Ophthalmol. 2012;96:783–7.
Trimmel J. Inequality and inequity in eye health. Community Eye 2016;29:1–3.
Wagner LD, Rein DB. Attributes associated with eye care use in the United States: a meta-analysis. Ophthalmology. 2013;120:1497–
Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, San- karidurg P, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123:1036–
Grzybowski A, Kanclerz P, Tsubota K, Lanca C, Saw SM. A review on the epidemiology of myopia in school children worldwide. BMC Ophthalmol. 2020;20:27.
Thompson S, Naidoo K, Gonzalez-Alvarez C, Harris G, China- nayi F, Loughman J. Barriers to use of refractive services in Optom Vis Sci. 2015;92:59–69.
Marmamula S, Keeffe JE, Raman U, Rao GN. Population-based cross-sectional study of barriers to utilisation of refraction services in South India: Rapid Assessment of Refractive Errors (RARE) BMJ Open. 2011;1:e000172.
Dhirar N, Dudeja S, Duggal M, Gupta PC, Jaiswal N, Singh M, et al. Compliance to spectacle use in children with refractive errors- a systematic review and meta-analysis. BMC Ophthalmol. 2020;20:71.
Labib TA, El Sada MA, Mohamed B, Sabra NM, Abdel Aleem Assessment and management of children with visual impairment. Middle East Afr J Ophthalmol. 2009;16:64–8.
O’Donoghue L, Rudnicka AR, McClelland JF, Logan NS, Saunders KJ. Visual acuity measures do not reliably detect childhood refractive error-an epidemiological study. PLoS 2012;7:e34441.
Qiu M, Wang SY, Singh K, Lin SC. Racial disparities in uncorrected and undercorrected refractive error in the United States. Invest Ophthalmol Vis Sci. 2014;55:6996–
Vos JJ, Padmos P, Boogaard J. Occupational testing of near Ophthalmic Physiol Opt. 1994;14:413–8.
Hashemi H, Khabazkhoob M, Nabovati P, Shahraki FA, Ostadi- moghaddam H, Faghihi M, et al. Accommodative insufﬁciency in a student population in J Optom. 2019;12:161–7.
Sterner B, Gellerstedt M, Sjöström Accommodation and therelationship to subjective symptoms with near work for youngschool children. Ophthalmic Physiol Opt. 2006;26: 148–55.
Lee SMY, Cho JCW. Low vision devices for children. Commun Eye Health. 2007;20:28–
Dijk KV. Providing care for children with low vision. Commun Eye Health. 2007;20:24–
Boyers LN, Karimkhani C, Hilton J, Richheimer W, Dellavalle RP. Global burden of eye and vision disease as reﬂected in the Cochrane Database of Systematic Reviews. JAMA Ophthalmol. 2015;133:25–
Courtright P, Hutchinson AK, Lewallen S. Visual impairment in children in middle- and lower-income countries. Arch Dis 2011;96:1129–34.
Adhikari S, Shrestha MK, Adhikari K, Maharjan N, Shrestha Factors associated with childhood ocular morbidity and blindness in 3 ecological regions of Nepal: Nepal pediatric ocular disease study. BMC Ophthalmol. 2014;14:125.
Stevens GA, White RA, Flaxman SR, Price H, Jonas JB, Keeffe J, et al. Vision loss expert group. global prevalence of vision impairment and blindness: magnitude and temporal trends, 1990- Ophthalmology. 2013;120:2377–84.

As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.

Faculty

Parya Abdolalizadeh, MD, MPH

Eye Research Center
The Five Senses Institute
Rassoul Akram Hospital
Iran University of Medical Sciences
Tehran, Iran

Disclosures

Disclosure: Parya Abdolalizadeh, MD, MPH, disclosed has no relevant financial relationships.

Samira Chaibakhsh, PhD

Eye Research Center
The Five Senses Institute
Rassoul Akram Hospital
Iran University of Medical Sciences
Neuromusculoskeletal Research Center
Iran University of Medical Sciences
Tehran, Iran

Disclosures

Disclosure: Samira Chaibakhsh, PhD, disclosed has no relevant financial relationships.

Khalil Ghasemi Falavarjani, MD

Eye Research Center
The Five Senses Institute
Rassoul Akram Hospital
Iran University of Medical Sciences
Stem Cell and Regenerative Medicine Research Center
Iran University of Medical Sciences
Tehran, Iran

Disclosures

Disclosure: Khalil Ghasemi Falavarjani, MD, disclosed has no relevant financial relationships.

CME Author

Laurie Barclay, MD

Freelance writer and reviewer
Medscape, LLC

Disclosures

Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

Sobha Sivaprasad, MD

Editor, Eye

Disclosures

Disclosure: Sobha Sivaprasad, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Allergan, Inc.; Apellis Pharmaceuticals; Bayer AG; Boehringer Ingelheim Pharmaceuticals, Inc.; Heidelberg Pharma GmbH; Novartis Pharmaceuticals Corporation; Oculis; Optos; Oxurion NV; Roche
Served as a speaker or a member of a speakers bureau for: Allergan, Inc.; Bayer AG; Novartis Pharmaceuticals Corporation; Optos
Received grants for clinical research from: Allergan, Inc.; Bayer AG; Boehringer Ingelheim Pharmaceuticals, Inc.; Novartis Pharmaceuticals Corporation; Optos

CME Reviewer

Esther Nyarko, PharmD

Associate Director, Accreditation and Compliance
Medscape, LLC

Disclosures

Disclosure: Esther Nyarko, PharmD, has disclosed no relevant financial relationships.

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

CME / ABIM MOC

Global Burden of Paediatric Vision Impairment: A Trend Analysis From 1990 to 2017

Authors: Parya Abdolalizadeh, MD, MPH; Samira Chaibakhsh, PhD; Khalil Ghasemi Falavarjani, MD
CME / ABIM MOC Released: 6/16/2021
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 6/16/2022, 11:59 PM EST

Start Activity

Target Audience and Goal Statement

This activity is intended for ophthalmologists, pediatricians, public health officials, and other clinicians caring for children with visual impairment.

The goal of this activity is to describe the global health burden of pediatric visual impairment across countries with different national levels of socioeconomic development and the time trends of this burden, according to a retrospective analysis of disability-adjusted life year (DALY) data available from the Global Burden of Disease (GBD) 2017 covering 3 age groups: 1 to 4 years (preschool children), 5 to 9 years (school children), and 10 to 14 years (teens).

Upon completion of this activity, participants will:

Describe DALYs caused by pediatric vision impairment in different age groups by socioeconomic indicators and other factors in 2017, according to a retrospective analysis of GBD data
Determine the trend from 1990 to 2017 in DALYs caused by pediatric vision impairment in different age groups, according to a retrospective analysis of GBD data
Identify clinical and public health implications of findings regarding DALYs caused by pediatric vision impairment in different age groups, according to a retrospective analysis of GBD data

Disclosures

Faculty

Parya Abdolalizadeh, MD, MPH

Eye Research Center
The Five Senses Institute
Rassoul Akram Hospital
Iran University of Medical Sciences
Tehran, Iran

Disclosures

Disclosure: Parya Abdolalizadeh, MD, MPH, disclosed has no relevant financial relationships.

Samira Chaibakhsh, PhD

Eye Research Center
The Five Senses Institute
Rassoul Akram Hospital
Iran University of Medical Sciences
Neuromusculoskeletal Research Center
Iran University of Medical Sciences
Tehran, Iran

Disclosures

Disclosure: Samira Chaibakhsh, PhD, disclosed has no relevant financial relationships.

Khalil Ghasemi Falavarjani, MD

Eye Research Center
The Five Senses Institute
Rassoul Akram Hospital
Iran University of Medical Sciences
Stem Cell and Regenerative Medicine Research Center
Iran University of Medical Sciences
Tehran, Iran

Disclosures

Disclosure: Khalil Ghasemi Falavarjani, MD, disclosed has no relevant financial relationships.

CME Author

Laurie Barclay, MD

Freelance writer and reviewer
Medscape, LLC

Disclosures

Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

Sobha Sivaprasad, MD

Editor, Eye

Disclosures

Disclosure: Sobha Sivaprasad, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Allergan, Inc.; Apellis Pharmaceuticals; Bayer AG; Boehringer Ingelheim Pharmaceuticals, Inc.; Heidelberg Pharma GmbH; Novartis Pharmaceuticals Corporation; Oculis; Optos; Oxurion NV; Roche
Served as a speaker or a member of a speakers bureau for: Allergan, Inc.; Bayer AG; Novartis Pharmaceuticals Corporation; Optos
Received grants for clinical research from: Allergan, Inc.; Bayer AG; Boehringer Ingelheim Pharmaceuticals, Inc.; Novartis Pharmaceuticals Corporation; Optos

CME Reviewer

Esther Nyarko, PharmD

Associate Director, Accreditation and Compliance
Medscape, LLC

Disclosures

Disclosure: Esther Nyarko, PharmD, has disclosed no relevant financial relationships.

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

Accreditation Statements

In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Springer Nature. Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

For Physicians

Medscape, LLC designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 75% on the post-test.

Follow these steps to earn CME/CE credit*:

Read about the target audience, learning objectives, and author disclosures.
Study the educational content online or print it out.
Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.

From Eye

CME / ABIM MOC

Global Burden of Paediatric Vision Impairment: A Trend Analysis From 1990 to 2017

Authors: Parya Abdolalizadeh, MD, MPH; Samira Chaibakhsh, PhD; Khalil Ghasemi Falavarjani, MDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME / ABIM MOC Released: 6/16/2021

Valid for credit through: 6/16/2022, 11:59 PM EST

processing....

Abstract and Introduction

Abstract

Objective To assess the trend of paediatric visual impairment and its disparities by year, sex, age and national socio- economic levels using disability-adjusted life years (DALYs).

Methods It is a retrospective analysis of data from the Global Burden of Disease (GBD) 2017. Global and national DALY numbers and rates of vision impairment in three paediatric age groups of 1–4 (preschool children), 5–9 (school children) and 10–14 years (teenagers) years were obtained from the GBD 2017 database. The socioeconomic indices for 195 countries were derived from international open databases. Main outcome measures were comparison of DALYs due to paediatric vision impairment in different age groups by socioeconomic indicators in 2017 and analysis of the trend from 1990.

Results The global prevalence of distance and/or near vision impairment for 1–14 years was 2.8% (95% uncertainty interval (UI): 2.5–3.1) in 2017. The highest DALYs for distance and/or near vision impairment [number=589.93 thousands (95%UI: 367.71–933.29), rate = 92.72 (95%UI: 57.79–146.68)] were observed in teenagers. DALY rate of distance and/or near vision impairment was not associated with socioeconomic indicators, however, DALY rate of refractive disorders had positive correlation with national socioeconomic development. The global trends of DALY numbers in distance and/or near vision impairment as well as refractive and other causes remained stable from 1990 to 2015 (0.128 ≤ P ≤ 0.738), however, DALY rates had a statistically signiﬁcant trend of reduction in all paediatric age groups (0.003 ≤ P ≤ 0.024).

Conclusion The global health burden of paediatric vision impairment decreased from 1990. Refractive, near vision impairment and other causes were associated with socioeconomic development.

Introduction

The global population with vision impairment was 252 million in 2015, among them 216 million people had low vision (3/60≤ visual acuity <6/18 in the better eye) and 16 million were blind (visual acuity <3/60 in the better eye) ^[1]. It has been estimated that the number of people with vision impairment will rise to 275 million by 2020, worldwide ^[1]. The Global Burden of Disease (GBD) study showed that vision impairment was the third-ranked disability in terms of disability-adjusted life years (DALY) after anaemia and hearing loss worldwide, from 1990 to 2017 ^[2]. Childhood blindness and visual impairment are important public health issues worldwide^[3]. The WHO estimated 1.4 million blind children (under 18 years) globally in 2000 ^[3]. According to the global estimation in 2010, 19 million children with ages less than 14 years had vision impairment ^[3].

In addition to the prevalence data, knowledge of the burden of paediatric vision impairment enables comparisons of epidemiologic patterns over time and across countries which is valuable for health policy making and resource allocations. The health burden of disease can be measured by DALY which compares the current status with an ideal condition in which people live up to the age of standard life expectancy in perfect health. The years lived with disability (YLD) part of DALY reﬂects both the age of onset and severity of the disability; more severe disability at younger age, the higher YLD. Therefore, health burden of paediatric vision impairment can be more devastating due to lower age of onset and the potential lifespan of children.

The health burden of common ocular diseases in adult age groups, including uncorrected refractive disorders, cataract, glaucoma and age-related macular degeneration has been already reported ^[4–8]. However, limited studies have focused on health burden of vision impairment in paediatric age groups notably considering the prevalence, not the DALY ^{[9, 10]}. Global estimations in 1999, reported an overall prevalence of 0.1 to 1.1 per 1000 children, with higher prevalence in low income countries ^[9]. The aim of this study was to evaluate the global health burden of paediatric visual impairment across countries with different national levels of socioeconomic development and its time trends using the DALY data available from the GBD 2017.

Page 1 of 5

Methods

CME / ABIM MOC Information

Abstract and Introduction
Methods
Results
Discussion
Summary

References

References

Disclaimer

The educational activity presented above may involve simulated, case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient, whether living or deceased, is intended or should be inferred. The material presented here does not necessarily reflect the views of Medscape, LLC, or any individuals or commercial entities that support companies that support educational programming on medscape.org. These materials may include discussion of therapeutic products that have not been approved by the US Food and Drug Administration, off-label uses of approved products, or data that were presented in abstract form. These data should be considered preliminary until published in a peer-reviewed journal. Readers should verify all information and data before treating patients or employing any therapies described in this or any educational activity. A qualified healthcare professional should be consulted before using any therapeutic product discussed herein.

References

Faculty and Disclosures

Faculty

Parya Abdolalizadeh, MD, MPH

Samira Chaibakhsh, PhD

Khalil Ghasemi Falavarjani, MD

CME Author

Laurie Barclay, MD

Sobha Sivaprasad, MD

CME Reviewer

Esther Nyarko, PharmD

CME / ABIM MOC

Global Burden of Paediatric Vision Impairment: A Trend Analysis From 1990 to 2017

Target Audience and Goal Statement

Disclosures

Faculty

Parya Abdolalizadeh, MD, MPH

Samira Chaibakhsh, PhD

Khalil Ghasemi Falavarjani, MD

CME Author

Laurie Barclay, MD

Sobha Sivaprasad, MD

CME Reviewer

Esther Nyarko, PharmD

Accreditation Statements

For Physicians

Instructions for Participation and Credit

Global Burden of Paediatric Vision Impairment: A Trend Analysis From 1990 to 2017

Abstract and Introduction

Abstract

Introduction

Table of Contents