Transcript The 3rd William H. Spencer, M.D. Lecture

International Council of Ophthalmology/
International Federation of Ophthalmological Societies
The Challenge:
Avoidable Blindness and
Visual Impairment
Worldwide
(Data from the World Health Organization - WHO)
The World Reality
(WHO Global database 2002)
230 studies
96 countries
Population based survey, WHO definition
Data from other sources and/or other definition
No data available
Magnitude (2002 population)
• Global estimate (best corrected VA)
– Visual impairment: 161 million
– of whom:
• 37 million Blind
• 124 million Low Vision
Visual Impairment
Regional Distribution
Eur
10%
Amr
10%
Sear
27%
Emr
10%
Afr
17%
Wpr
26%
Best corrected
Visual Acuity
< 6/18 (0.3)
Number of Visually Impaired
(per Million Population)
45,000
40,000
35,000
30,000
25,000
20,000
15,000
10,000
5,000
Afr
Emr
Sear
Wpr
Amr
Eur
Global Distribution of Blindness
(by Cause)
1995 vs. 2002
Other
13 %
Other
28 %
Cataract
42 %
Cataract
47 %
Ch Bl
4%
Oncho.
1%
Glaucoma
14%
ARMD
9%
Trachoma
15 %
1995
DR
5%
CO
5%
Oncho.
1%
Glaucoma Trachoma
4%
12%
2002
Original factors remain unchanged…
Global Trends in Blindness
70
Vision
2020
still
relevant!
60
50
40
30
20
10
0
1990 1992
1994 1996
1998
2000 2002
2004 2006
Ageing + Population growth + Underdevelopment
Cataract Surgical Rate < 500
< 125
125- 249
250 - 499
Immediate Implications
Unfinished agenda:
• Refractive Errors
• Trachoma
• Onchocerciasis
• Xerophthalmia
• Cataract
• Diabetic Retinopathy
• Glaucoma
Medium/Long Term Implications
• Changing Patterns:
– More linked to lifestyle, chronic
diseases
– Age-related Macula Degeneration
– 3rd Global Cause
– 1st Cause in an increasing # of
countries
Number of Persons with Diabetes
(in millions)
90
2000
2030
80
70
60
50
40
30
20
10
0
Est market
ec
Former
soc.ec Eur
India
China
Latin
Middle East
Amer&Car
Other
Asia&Isl
SubSaharan Afr
WHO, Wild & Roglic, 2004