The Evolution of Uncorrected Refractive Error as a Major Public Health Issue

Uncorrected refractive error has only recently (2006) been formally recognised as a significant cause of blindness and the major cause of impaired vision in the world. It is now known that over 625 million people have uncorrected refractive error (for distance and near vision), simply because of a lack of an eye examination and appropriate spectacles. Accumulating evidence indicates that myopic macular degeneration (MMD) is a major cause of vision impairment and blindness – but this contribution of MMD to blindness prevalence is yet to be recognised by the World Health Organization (WHO) and national research bodies such as the US National Eye Institute (NEI). In 2010, there were an estimated 1.7 billion myopes worldwide – predicted to increase to around 2.2 billion by 2020 – with a small but significant percentage of those affected likely to progress to high myopia. High myopia significantly increases the risk of blinding conditions such as MMD, glaucoma and cataract. This article details the crucial epidemiological work and advocacy efforts that have positioned uncorrected refractive error on the global health agenda and charts the evolution of myopia as a major public health issue which still requires a supreme coordinated effort to combat this encroaching ‘epidemic’.