Abstract
The prevalence of visual impairment (VI) continues to rise, despite efforts to reduce it. The burden of disease negatively impacts the quality of life, education opportunities, and other developments in various communities. Henceforth, this study aimed to determine and quantify the major causes of VI in South Africa, to ensure accurate interventions in addressing them and to reduce the burden of ocular disease in that context. A systematic scoping review was conducted to map evidence on VI and ocular diseases, using the PRISMA-P guidelines. English studies were searched for on PubMed, Google Scholar, and EBSCOhost using various search terms. The eligible articles underwent screening and ultimately data extraction to identify major causes of VI in South Africa. A meta-analysis further resulted in pooled prevalence estimates (PPE) using the Inverse Variance Heterogeneity (IVhet) model. Of the 13,527 studies screened at three levels, 10 studies met the inclusion criteria for the final review; however, 9 studies were eligible for quality assessment performed by two independent reviewers. The quality index for the included studies was 71.1%. The prevalence of VI was 2% for blindness and 12% for moderate and severe visual impairment (MSVI). Pooled prevalence identified uncorrected refractive error (URE) (43%), cataract (28%), glaucoma (7%), and diabetic retinopathy (4%) as major causes of MSVI. The leading causes of blindness were untreated cataracts (54%), glaucoma (17%), and diabetic retinopathy (57%). Ocular diseases causing VI are avoidable and similar to those of low-to-middle income countries. MSVI were caused by URE, cataract, glaucoma, and diabetic retinopathy. Blindness was mainly caused by cataracts, glaucoma, and diabetic retinopathy. A strategic plan to manage these conditions would largely reduce the burden of VI in the country. Early screenings and interventions to maximize care at primary health levels would decrease the burden of avoidable blindness in the country significantly.
Highlights
With a global population of 217 million people having moderate to severe visual impairment (VI) and 36 million blind people [1], the challenge of reduced vision remains a serious public health challenge
As an enabler of development and growth [2,5], good vision improves the chances of employability, much needed in a region burdened by poverty such as Sub-Saharan Africa (SSA) [8,9]
Our study suggests that the leading cause of VI was uncorrected refractive error (URE), while diabetic retinopathy (DR) was the least cause of VI
Summary
With a global population of 217 million people having moderate to severe visual impairment (VI) and 36 million blind people [1], the challenge of reduced vision remains a serious public health challenge. The majority of the affected individuals are from low to middle-income countries [3], which are heavily affected by other diseases such as neglected tropical diseases (NTDs), malaria, and tuberculosis, among others [4]. These health challenges in addition to visual impairment (VI) have far-reaching consequences that lead to reduced educational opportunities, minimal economic participation, increased rates of poverty, and reduced economic development amongst the disabled [1,5,6]. As an enabler of development and growth [2,5], good vision improves the chances of employability, much needed in a region burdened by poverty such as Sub-Saharan Africa (SSA) [8,9]
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