Abstract
SummaryBackgroundWe undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations.MethodsDrawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists.FindingsBetween Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity.InterpretationThis list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenges.FundingThe Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity, National Institute for Health Research Moorfields Biomedical Research Centre, Wellcome Trust, Sightsavers, The Fred Hollows Foundation, The Seva Foundation, British Council for the Prevention of Blindness, and Christian Blind Mission.TranslationsFor the French, Spanish, Chinese, Portuguese, Arabic and Persian translations of the abstract see Supplementary Materials section.
Highlights
Eye health has been defined as “the state in which vision, ocular health, and functional ability are maximised, thereby contributing to overall health and wellbeing, social inclusion, and quality of life”.1 In 2020, an estimated 43 million people were blind, a further 295 million had moderate or severe distance vision impairment, 258 million had mild distance vision impairment, and 510 million had near vision impairment.[2]
The most common causes of vision impairment after cataract and refractive error are age-related macular degeneration, glaucoma, and diabetic retinopathy,[6] all of which would benefit from the development of improved case finding
We reviewed reference lists of all eye health prioritisation processes, identified studies citing them, and asked experts in the field whether they were aware of any further processes
Summary
Eye health has been defined as “the state in which vision, ocular health, and functional ability are maximised, thereby contributing to overall health and wellbeing, social inclusion, and quality of life”.1 In 2020, an estimated 43 million people were blind, a further 295 million had moderate or severe distance vision impairment, 258 million had mild distance vision impairment, and 510 million had near vision impairment.[2]. More than three-quarters of cases of distance vision impairment are due to cataract or uncorrected refractive error,[6] conditions for which efficacious interventions exist but remain inaccessible to many and have not been effective. This differential access to good quality eye-care services creates and sustains inequity in terms of who remains vision impaired.[1,2]. This differential access to good quality eye-care services creates and sustains inequity in terms of who remains vision impaired.[1,2] The most common causes of vision impairment after cataract and refractive error are age-related macular degeneration, glaucoma, and diabetic retinopathy,[6] all of which would benefit from the development of improved case finding
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