Global Visual Impairment Research Articles

Curcumin in Ophthalmology: Mechanisms, Challenges, and Emerging Opportunities

Ocular diseases affecting the anterior and posterior segments of the eye are major causes of global vision impairment. Curcumin, a natural polyphenol, exhibits anti-inflammatory, antioxidant, antibacterial, and neuroprotective properties, making it a promising candidate for ocular therapy. However, its clinical use is hindered by low aqueous solubility, poor bioavailability, and rapid systemic elimination. This review comprehensively highlights advances in curcumin delivery systems aimed at overcoming these challenges. Emerging platforms, including proniosomal gels, transferosomes, and cyclodextrin complexes, have improved solubility, permeability, and ocular retention. Nanoparticle-based carriers, such as hybrid hydrogels and biodegradable nanoparticles, enable sustained release and targeted delivery, supporting treatments for posterior segment diseases like diabetic retinopathy and age-related macular degeneration. For anterior segment conditions, including keratitis and dry eye syndrome, cyclodextrin-based complexes and mucoadhesive systems enhance corneal permeability and drug retention. Mechanistically, curcumin modulates key pathways, such as NF-κB and TLR4, reducing oxidative stress, angiogenesis, and apoptosis. Emerging strategies like photodynamic therapy and neuroprotective approaches broaden their application to eyelid conditions and neuroinflammatory ocular diseases. These advancements address curcumin’s pharmacokinetic limitations, supporting its clinical translation into ophthalmic therapies. This work underscores curcumin’s potential in ocular disease management and advocates clinical trials to validate its safety, efficacy, and therapeutic relevance.

Age–period–cohort analysis of the global burden of visual impairment according to major causes: an analysis of the Global Burden of Disease Study 2019

BackgroundCataract, glaucoma and age-related macular degeneration (AMD) are major causes of visual impairment. As these are age-related conditions, the prevalence of associated visual impairment is anticipated to increase as the...

Development of an in-situ forming collagen-based hydrogel as a regenerative bioadhesive for corneal perforations

Corneal injuries play a significant role in global visual impairment, underscoring the demand for innovative biomaterials with specific attributes such as adhesion, cohesion, and regenerative potential. In this study, we have developed a biocompatible bioadhesive for corneal reconstruction. Derived from Collagen type I, naturally present in human corneal stromal tissue, the bioadhesive was cross-linked with modified polyethylene glycol diacrylate (PEGDA-DOPA), rendering it curable through visible light exposure and exhibiting superior adhesion to biological tissues even in wet conditions. The physicochemical characteristics of the proposed bioadhesive were customized by manipulating the concentration of its precursor polymers and adjusting the duration of photocrosslinking. To identify the optimal sample with maximum adhesion, mechanical strength, and biocompatibility, characterization tests were conducted. The optimal specimen, consisting of 30 % (w/v) PEGDA-DOPA and cured with visible light for 5 min, exhibited commendable adhesive strength of 783.6 kPa and shear strength of 53.7 kPa, surpassing that of commercialized eye adhesives.Additionally, biocompatibility test results indicated a notably high survival rate (>100 %) of keratocytes seeded on the hydrogel adhesive after 7 days of incubation. Consequently, this designed bioadhesive, characterized by high adhesion strength, robust mechanical strength, and excellent biocompatibility, is anticipated to enhance the spontaneous repair process of damaged corneal stromal tissue.

Trends in the global burden of vision loss among the older adults from 1990 to 2019.

To quantify the global impact of vision impairment in individuals aged 65 years and older between 1990 and 2019, segmented by disease, age, and sociodemographic index (SDI). Using the Global Burden of Diseases 2019 (GBD 2019) dataset, a retrospective demographic evaluation was undertaken to ascertain the magnitude of vision loss over this period. Metrics evaluated included case numbers, prevalence rates per 100,000 individuals, and shifts in prevalence rates via average annual percentage changes (AAPCs) and years lived with disability (YLDs). From 1990 to 2019, vision impairment rates for individuals aged 65 years and older increased from 40,027.0 (95% UI: 32,232.9-49,945.1) to 40,965.8 (95% UI: 32,911-51,358.3, AAPC: 0.11). YLDs associated with vision loss saw a significant decrease, moving from 1713.5 (95% UI: 1216.2-2339.7) to 1579.1 (95% UI: 1108.3-2168.9, AAPC: -0.12). Gender-based evaluation showed males had lower global prevalence and YLD rates compared to females. Cataracts and near vision impairment were the major factors, raising prevalence by 6.95 and 2.11%, respectively. Cataract prevalence in high-middle SDI regions and near vision deficits in high SDI regions significantly influenced YLDs variation between 1990 and 2019. Over the past three decades, there has been a significant decrease in the vision impairment burden in individuals aged 65 and older worldwide. However, disparities continue, based on disease type, regional SDI, and age brackets. Enhancing eye care services, both in scope and quality, is crucial for reducing the global vision impairment burden among the older adults.

Improved Support Vector Machine based on CNN-SVD for vision-threatening diabetic retinopathy detection and classification.

The integration of artificial intelligence (AI) in diagnosing diabetic retinopathy, a major contributor to global vision impairment, is becoming increasingly pronounced. Notably, the detection of vision-threatening diabetic retinopathy (VTDR) has been significantly fortified through automated techniques. Traditionally, the reliance on manual analysis of retinal images, albeit slow and error-prone, constituted the conventional approach. Addressing this, our study introduces a novel methodology that amplifies the robustness and precision of the detection process. This is complemented by the groundbreaking Hierarchical Block Attention (HBA) and HBA-U-Net architecture, which notably propel attention mechanisms in image segmentation. This innovative model refines image processing without imposing excessive computational demands by honing in on individual pixel intricacies, spatial relationships, and channel-specific attention. Building upon this innovation, our proposed method employs a multi-stage strategy encompassing data pre-processing, feature extraction via a hybrid CNN-SVD model, and classification employing an amalgamation of Improved Support Vector Machine-Radial Basis Function (ISVM-RBF), DT, and KNN techniques. Rigorously tested on the IDRiD dataset classified into five severity tiers, the hybrid model yields remarkable performance, achieving a 99.18% accuracy, 98.15% sensitivity, and 100% specificity in VTDR detection, thus surpassing existing methods. These results underscore a more potent avenue for diagnosing and addressing this crucial ocular condition while underscoring AI's transformative potential in medical care, particularly in ophthalmology.

Granular polyrotaxane microgels as injectable hydrogels for corneal tissue regeneration.

Corneal diseases, a leading cause of global vision impairment, present challenges in treatment due to corneal tissue donor scarcity and transplant rejection. Hydrogel biomaterials in the form of corneal implants for tissue regeneration, while promising, have faced obstacles related to cellular and tissue integration. This study develops and investigates the potential of granular polyrotaxane (GPR) hydrogels as a scaffold for corneal keratocyte growth and transparent tissue generation. Employing host-guest driven supramolecular interactions, we developed injectable, cytocompatible hydrogels. By optimizing cyclodextrin (CD) concentrations in thiol-ene crosslinked PEG microgels, we observed improved mechanical properties and thermoresponsiveness while preserving injectability. These microgels, adaptable for precise defect filling, 3D printing or tissue culture facilitate enhanced cellular integration with corneal keratocytes and exhibit tissue-like structures in culture. Our findings demonstrate the promise of GPR hydrogels as a minimally invasive avenue for corneal tissue regeneration. These results have the potential to address transplantation challenges, enhance clinical outcomes, and restore vision.

Micro-segmentation of retinal image lesions in diabetic retinopathy using energy-based fuzzy C-Means clustering (EFM-FCM).

Diabetic retinopathy (DR) is a prevalent cause of global visual impairment, contributing to approximately 4.8% of blindness cases worldwide as reported by the World Health Organization (WHO). The condition is characterized by pathological abnormalities in the retinal layer, including microaneurysms, vitreous hemorrhages, and exudates. Microscopic analysis of retinal images is crucial in diagnosing and treating DR. This article proposes a novel method for early DR screening using segmentation and unsupervised learning techniques. The approach integrates a neural network energy-based model into the Fuzzy C-Means (FCM) algorithm to enhance convergence criteria, aiming to improve the accuracy and efficiency of automated DR screening tools. The evaluation of results includes the primary dataset from the Shiva Netralaya Centre, IDRiD, and DIARETDB1. The performance of the proposed method is compared against FCM, EFCM, FLICM, and M-FLICM techniques, utilizing metrics such as accuracy in noiseless and noisy conditions and average execution time. The results showcase auspicious performance on both primary and secondary datasets, achieving accuracy rates of 99.03% in noiseless conditions and 93.13% in noisy images, with an average execution time of 16.1 s. The proposed method holds significant potential in medical image analysis and could pave the way for future advancements in automated DR diagnosis and management. RESEARCH HIGHLIGHTS: A novel approach is proposed in the article, integrating a neural network energy-based model into the FCM algorithm to enhance the convergence criteria and the accuracy of automated DR screening tools. By leveraging the microscopic characteristics of retinal images, the proposed method significantly improves the accuracy of lesion segmentation, facilitating early detection and monitoring of DR. The evaluation of the method's performance includes primary datasets from reputable sources such as the Shiva Netralaya Centre, IDRiD, and DIARETDB1, demonstrating its effectiveness in comparison to other techniques (FCM, EFCM, FLICM, and M-FLICM) in terms of accuracy in both noiseless and noisy conditions. It achieves impressive accuracy rates of 99.03% in noiseless conditions and 93.13% in noisy images, with an average execution time of 16.1 s.

Intravitreal implants manufactured by supercritical foaming for treating retinal diseases

Chronic retinal diseases, such as age-related macular degeneration (AMD), are a major cause of global visual impairment. However, current treatment methods involving repetitive intravitreal injections pose financial and health burdens for patients. The development of controlled drug release systems, particularly for biological drugs, is still an unmet need in prolonging drug release within the vitreous chamber. To address this, green supercritical carbon dioxide (scCO2) foaming technology was employed to manufacture porous poly(lactic-co-glycolic acid) (PLGA)-based intravitreal implants loaded with dexamethasone. The desired implant dimensions were achieved through 3D printing of customised moulds. By varying the depressurisation rates during the foaming process, implants with different porosities and dexamethasone release rates were successfully obtained. These implants demonstrated controlled drug release for up to four months, surpassing the performance of previously developed implants. In view of the positive results obtained, a pilot study was conducted using the monoclonal antibody bevacizumab to explore the feasibility of this technology for preparing intraocular implants loaded with biologic drug molecules. Overall, this study presents a greener and more sustainable alternative to conventional implant manufacturing techniques, particularly suited for drugs that are susceptible to degradation under harsh conditions.

Integrating eye care in low-income and middle-income settings: a scoping review

ObjectivesIntegrated people-centred eye care has been recommended as a strategic framework for reducing global vision impairment and blindness. The extent to which eye care has integrated with other services has...

Factors associated with visual outcome after traumatic hyphema following closed globe injury due to blunt trauma: A tertiary care center study

Background: Ocular trauma and its complications are a significant contributor to global visual impairment and often present as an ophthalmic emergency in medical care facilities. Timely intervention is crucial for final visual outcome. Aims and Objectives: This study aimed to identify the factors that are correlated with the final visual outcome in cases of traumatic hyphema in a closed globe injury (CGI). Materials and Methods: A single-centric, prospective, interventional study was conducted in a tertiary care hospital. Fifty-three consecutive patients were enrolled in the study over a period of 1 year 5 months who presented with traumatic hyphema due to blunt trauma. Patients with a head injury, any blood dyscrasia, on blood thinners, associated with eye injury other than traumatic and unwilling patients were excluded from the study. Data analysis was done using statistical package for the social sciences software. Results: There was male preponderance. Majority of the study population were in the second decade. Best-corrected visual acuity (BCVA) was affected more among those who had hyphema of Grade-II or higher (P = 0.017). BCVA on presentation, posterior segment injury (P = 0.001) was found to be major determinant. Conclusion: We conclude traumatic cataract, corneal blood staining, secondary hemorrhage, time interval between the injury and presentation, BCVA at presentation, posterior segment injuries such as retinal detachment, berlin’s edema, optic atrophy, glaucoma are the major factors that determine the visual outcome. A handful of studies are available in literature regarding the visual outcome in patients with hyphema in CGI due to blunt trauma, but no such study is available from this part of the country.

Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study

SummaryBackgroundTo contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990–2020, and forecasts for 2050.MethodsWe did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. Only studies with samples representative of the population and with clearly defined visual acuity testing protocols were included. We fitted hierarchical models to estimate 2020 prevalence (with 95% uncertainty intervals [UIs]) of mild vision impairment (presenting visual acuity ≥6/18 and <6/12), moderate and severe vision impairment (<6/18 to 3/60), and blindness (<3/60 or less than 10° visual field around central fixation); and vision impairment from uncorrected presbyopia (presenting near vision <N6 or <N8 at 40 cm where best-corrected distance visual acuity is ≥6/12). We forecast estimates of vision loss up to 2050.FindingsIn 2020, an estimated 43·3 million (95% UI 37·6–48·4) people were blind, of whom 23·9 million (55%; 20·8–26·8) were estimated to be female. We estimated 295 million (267–325) people to have moderate and severe vision impairment, of whom 163 million (55%; 147–179) were female; 258 million (233–285) to have mild vision impairment, of whom 142 million (55%; 128–157) were female; and 510 million (371–667) to have visual impairment from uncorrected presbyopia, of whom 280 million (55%; 205–365) were female. Globally, between 1990 and 2020, among adults aged 50 years or older, age-standardised prevalence of blindness decreased by 28·5% (–29·4 to −27·7) and prevalence of mild vision impairment decreased slightly (–0·3%, −0·8 to −0·2), whereas prevalence of moderate and severe vision impairment increased slightly (2·5%, 1·9 to 3·2; insufficient data were available to calculate this statistic for vision impairment from uncorrected presbyopia). In this period, the number of people who were blind increased by 50·6% (47·8 to 53·4) and the number with moderate and severe vision impairment increased by 91·7% (87·6 to 95·8). By 2050, we predict 61·0 million (52·9 to 69·3) people will be blind, 474 million (428 to 518) will have moderate and severe vision impairment, 360 million (322 to 400) will have mild vision impairment, and 866 million (629 to 1150) will have uncorrected presbyopia.InterpretationAge-adjusted prevalence of blindness has reduced over the past three decades, yet due to population growth, progress is not keeping pace with needs. We face enormous challenges in avoiding vision impairment as the global population grows and ages.FundingBrien Holden Vision Institute, Fondation Thea, Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.

Characterization of an i.p. D-galactose-induced cataract model in rats

Cataracts have been identified as a main cause of global visual impairment and blindness; in addition, diabetic and aging cataracts are the most common types. The aim of this project was to develop a suitable animal model and investigate the key points of the mechanisms by which intraperitoneal (i.p.) injection of D-galactose forms cataracts. We optimized a method to investigate the safest and effective method and dosage; rats in Group H were treated with 50% D-galactose 15 g/kg i.p. twice daily based on the 11 different treatment methods. The simple oral group showed considerable differences in the same observed time, while the i.p. group showed relatively uniform cataracts due to intake of the same dose of D-galactose. The data suggest that i.p. injection of galactose is a relatively more successful and stable cataract-inducing method with a low mortality rate. Based on this model, we found that Na+/K+ ratios had important relevance for galactose cataract formation, and we used scanning electron microscopy (SEM), inductively coupled plasma mass spectrometry (ICP-MS), enzyme-linked immunosorbent assay (ELISA) and immunofluorescence examinations to test and verify this.

Announcing The Lancet Global Health Commission on Global Eye Health

Announcing The Lancet Global Health Commission on Global Eye Health

Новые данные и тенденции в распространении и причинах глобальных нарушений зрения: База Данных Global Vision

Новые данные и тенденции в распространении и причинах глобальных нарушений зрения: База Данных Global Vision

Visual impairment people towards vision 2020 � A Review

Objectives: To make a perception about the differently disabled people on their problems and responsibility of the society to overcome their problems. Methods/Statistical Analysis: The review is done by the articles which deals with global visual impairment data along with device and technologies mainly used for Visually Impaired people. For analysis, different methods are analyzed to identify the causes and device implementation to enable an independent life. The characteristics of differently abled people are well identified through the analysis. Findings: In vision 2020 survey, various impacts on specialized people using smart technologies reduce their vision problems. Application/Improvements: This framework design measures the merits and demerits of smart technologies used to maintain the quality life of disable people. Keywords: Aided Devices, Disabled People, Sensor Network, Visual Impairment

Glaucoma in Asia- An epidemiological perspective.

Glaucoma is the third most common cause of global visual impairment. Bilateral blindness from glaucoma is projected to affect greater than 11 million individuals worldwide by the year 2020, with a disproportionately large number of the affected individuals being of Asian descent. The disease pattern, its response to treatment, and ground realities differ among various Asian countries. Over the past decade, there have been tremendous efforts for combating cataract blindness, but unfortunately few efforts in Asian countries have been made to establish comprehensive eye care programs in the community that include management of glaucoma. There is a need for education about the disease amongst the general public and continuing medical education and training of practicing ophthalmologists in addition to improvement of infrastructure to combat blindness due to glaucoma.

Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis.

Global and regional prevalence estimates for blindness and vision impairment are important for the development of public health policies. We aimed to provide global estimates, trends, and projections of global blindness and vision impairment. We did a systematic review and meta-analysis of population-based datasets relevant to global vision impairment and blindness that were published between 1980 and 2015. We fitted hierarchical models to estimate the prevalence (by age, country, and sex), in 2015, of mild visual impairment (presenting visual acuity worse than 6/12 to 6/18 inclusive), moderate to severe visual impairment (presenting visual acuity worse than 6/18 to 3/60 inclusive), blindness (presenting visual acuity worse than 3/60), and functional presbyopia (defined as presenting near vision worse than N6 or N8 at 40 cm when best-corrected distance visual acuity was better than 6/12). Globally, of the 7·33 billion people alive in 2015, an estimated 36·0 million (80% uncertainty interval [UI] 12·9-65·4) were blind (crude prevalence 0·48%; 80% UI 0·17-0·87; 56% female), 216·6 million (80% UI 98·5-359·1) people had moderate to severe visual impairment (2·95%, 80% UI 1·34-4·89; 55% female), and 188·5 million (80% UI 64·5-350·2) had mild visual impairment (2·57%, 80% UI 0·88-4·77; 54% female). Functional presbyopia affected an estimated 1094·7 million (80% UI 581·1-1686·5) people aged 35 years and older, with 666·7 million (80% UI 364·9-997·6) being aged 50 years or older. The estimated number of blind people increased by 17·6%, from 30·6 million (80% UI 9·9-57·3) in 1990 to 36·0 million (80% UI 12·9-65·4) in 2015. This change was attributable to three factors, namely an increase because of population growth (38·4%), population ageing after accounting for population growth (34·6%), and reduction in age-specific prevalence (-36·7%). The number of people with moderate and severe visual impairment also increased, from 159·9 million (80% UI 68·3-270·0) in 1990 to 216·6 million (80% UI 98·5-359·1) in 2015. There is an ongoing reduction in the age-standardised prevalence of blindness and visual impairment, yet the growth and ageing of the world's population is causing a substantial increase in number of people affected. These observations, plus a very large contribution from uncorrected presbyopia, highlight the need to scale up vision impairment alleviation efforts at all levels. Brien Holden Vision Institute.

Global Vision Impairment and Blindness Due to Uncorrected Refractive Error, 1990-2010.

The purpose of this systematic review was to estimate worldwide the number of people with moderate and severe visual impairment (MSVI; presenting visual acuity <6/18, ≥3/60) or blindness (presenting visual acuity <3/60) due to uncorrected refractive error (URE), to estimate trends in prevalence from 1990 to 2010, and to analyze regional differences. The review focuses on uncorrected refractive error which is now the most common cause of avoidable visual impairment globally. : The systematic review of 14,908 relevant manuscripts from 1990 to 2010 using Medline, Embase, and WHOLIS yielded 243 high-quality, population-based cross-sectional studies which informed a meta-analysis of trends by region. The results showed that in 2010, 6.8 million (95% confidence interval [CI]: 4.7-8.8 million) people were blind (7.9% increase from 1990) and 101.2 million (95% CI: 87.88-125.5 million) vision impaired due to URE (15% increase since 1990), while the global population increased by 30% (1990-2010). The all-age age-standardized prevalence of URE blindness decreased 33% from 0.2% (95% CI: 0.1-0.2%) in 1990 to 0.1% (95% CI: 0.1-0.1%) in 2010, whereas the prevalence of URE MSVI decreased 25% from 2.1% (95% CI: 1.6-2.4%) in 1990 to 1.5% (95% CI: 1.3-1.9%) in 2010. In 2010, URE contributed 20.9% (95% CI: 15.2-25.9%) of all blindness and 52.9% (95% CI: 47.2-57.3%) of all MSVI worldwide. The contribution of URE to all MSVI ranged from 44.2 to 48.1% in all regions except in South Asia which was at 65.4% (95% CI: 62-72%). : We conclude that in 2010, uncorrected refractive error continues as the leading cause of vision impairment and the second leading cause of blindness worldwide, affecting a total of 108 million people or 1 in 90 persons.

Pattern recognition receptors in microbial keratitis.

Microbial keratitis is a significant cause of global visual impairment and blindness. Corneal infection can be caused by a wide variety of pathogens, each of which exhibits a range of mechanisms by which the immune system is activated. The complexity of the immune response to corneal infection is only now beginning to be elucidated. Crucial to the cornea's defences are the pattern-recognition receptors: Toll-like and Nod-like receptors and the subsequent activation of inflammatory pathways. These inflammatory pathways include the inflammasome and can lead to significant tissue destruction and corneal damage, with the potential for resultant blindness. Understanding the immune mechanisms behind this tissue destruction may enable improved identification of therapeutic targets to aid development of more specific therapies for reducing corneal damage in infectious keratitis. This review summarises current knowledge of pattern-recognition receptors and their downstream pathways in response to the major keratitis-causing organisms and alludes to potential therapeutic approaches that could alleviate corneal blindness.

Design of ATM Accessing System for Blind using Real-Time Video Processing through Gestures

million people are visually impaired worldwide: 39 million are blind and 246 million have low vision (severe or moderate visual impairment) preventable cause are as high as 80% of the total global visual impairment burden. Globally, uncorrected refractive errors are the main cause of visual impairment. Cataracts are the leading cause of blindness 65% of visually impaired, and 82% of blind people are over 50 years of age, although this age group comprises only 20% of the world population(1).Blindness can be classified into 3 types, Complete blindness, Night blindness, Color blindness. The main problems faced by blind people: during financial transactions especially in ATMs. In the existing ATMs, Braille is inscribed on the keypad to facilitate blind. But, What if the people doesn't know Braille, how to insert a card? The friend accompanying him might get to know the password or someone else can come to know of his pin number. A stranger might try to help the blind win the trust and rob him. So, we propose to design and develop a safer and secure ATM accessing system for the blind.