Toward Universal Eye Health Coverage-Key Outcomes of the World Health Organization Package of Eye Care Interventions: A Systematic Review

Despite persistent inequalities in access to eye care services globally, guidance on a set of recommended, evidence-based eye care interventions to support country health care planning has not been available. To overcome this barrier, the World Health Organization (WHO) Package of Eye Care Interventions (PECI) has been developed. This Systematic Review describes the key outcomes of the PECI development.

Fifteen priority eye conditions were chosen. The literature search identified 3601 articles. Of these, 469 passed title and abstract screening, 151 passed full-text screening, 98 passed quality appraisal, and 87 were selected for data extraction. Little evidence (≤1 CPG identified) was available for pterygium, keratoconus, congenital eyelid disorders, vision rehabilitation, myopic macular degeneration, ptosis, entropion, and ectropion. In stage 3, domain-specific expert groups voted to include 135 interventions (57%) of a potential 235 interventions collated from stage 2. After synthesis across all interventions and eye conditions, 64 interventions (13 health promotion and education, 6 screening and prevention, 38 treatment, and 7 rehabilitation) were included in the PECI.

This systematic review identified 64 essential, evidence-based, eye care interventions that are required to achieve universal eye health coverage. The review also identified some important gaps.

Publication date

January 12, 2022


JAMA Ophthalmology

Sponsor Institution

Package of Eye Care Interventions Development Group


Stuart Keel; Gareth Lingham; Neha Misra; Sandra Block; Rupert Bourne; Margarita Calonge; Ching-Yu Cheng; David S Friedman; João M Furtado; Rohit Khanna; Silvio Mariotti; Wanjiku Mathenge; Elenoa Matoto; Andreas Müeller; Mansur Rabiu; Tuwani Rasengane; Serge Resnikoff; Richard Wormald; Sumrana Yasmin; Jialiang Zhao; Jennifer R Evans; Alarcos Cieza
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