Effective refractive error coverage in adults aged 50 years and older: estimates from population-based surveys in 61 countries

The World Health Organization (WHO) set a global target to achieve a 40-percentage-point increase in effective refractive error coverage (eREC) with a 6/12 visual acuity threshold by 2030. To establish a baseline for this initiative, the Vision Loss Expert Group conducted a study to model global and regional estimates of eREC. They analyzed data from 169 population-based eye surveys conducted since 2000, involving 565,448 participants, to calculate eREC. A binary logistic regression model was used to estimate eREC among adults aged 50 years and older in different regions. Findings revealed variations in eREC across regions in 2021: the high-income super region had 79.1% coverage, while sub-Saharan Africa had only 5.7%. Distance eREC increased globally by 19% from 2000 to 2021. However, achieving the WHO target would require significant improvements in the quantity and quality of refractive services, especially for near vision impairment. The study also highlighted gender inequity, with higher eREC among men, and decreased eREC with increasing age. Given that uncorrected refractive error is a leading cause of vision impairment worldwide, this study emphasizes the importance of addressing this issue. Efforts should focus on ensuring effective refractive services are accessible, particularly for near vision impairment. The study provides crucial data to guide global and regional strategies for eye care, aiming to reduce vision impairment and promote equitable eye health services.

Publication date

October 11, 2022


The Lancet Global Health

Sponsor Institution

WHO, Sightsavers, The Fred Hollows Foundation, Fondation Thea, Brien Holden Vision Institute, Lions Clubs International Foundation


Rupert Richard Alexander Bourne, Maria Vittoria Cicinelli, Tabassom Sedighi, Ian H Tapply, Ian McCormick, Jost B Jonas, Nathan G Congdon, Jacqueline Ramke, Kovin S Naidoo, Timothy R Fricke, Matthew J Burton, Andreas Müller, Mukharram M Bikbov, João M Furtado, Fatima Kyari, Mingguang He, Ya Xing Wang, Lingam Vijaya, Vinay Nangia, Garry Brian, Mohammad Hassan Emamian, Akbar Fotouhi, Hassan Hashemi, Rajiv B Khandekar, Srinivas Marmamula, Solange Salomão, Ronnie George, Gyulli Kazakbaeva, Tasanee Braithwaite, Robert J Casson, Aiko Iwase, Noopur Gupta, Mohammad H Abdianwall, Rohit Varma, Tien Y Wong, Ningli Wang, Hugh R Taylor, Seth R Flaxman, Stuart Keel, Serge Resnikoff
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