Review: Vision Impairment and Blindness

PAGE 8 of 10

View Table of Contents

The VEHSS team conducted a review of published literature on examination-based population studies reporting the prevalence of vision impairment and blindness.

Vision impairment (VI) is generally determined by measuring the best-corrected visual acuity (BCVA) of the better-seeing eye. Most studies in the United States measure visual acuity at a distance of 20 feet using the standardized Snellen Eye Chart.(Segre, 2015) Autorefractors may also be used to assess visual acuity and to estimate lens prescription. BCVA is a person’s best distance vision while using optimal refraction correction (eye glasses, contact lenses, laser surgery).(Segre, 2015) There is no universal definition of visual impairment and there are varying definitions of BCVA, including 20/40 to 20/63 (mild VI), 20/80 to 20/160 (moderate VI), 20/200 or worse (severe VI).(Varma, 2004) Legal blindness is defined by the US government (to determine eligibility for vocational training, rehabilitation, schooling, disability benefits, low vision devices, and tax exemption programs) as 20/200 or worse, and by the World Health Organization as 20/400 or worse.

Vision Impairment and Blindness Literature Review Results

There were 12 studies published between 1995 and 2016 that examined the prevalence of vision impairment and blindness.

Table 1. Vision Impairment and Blindness Prevalence Sources.

Figure 6.0 Vision Impairment and Blindness Prevalence Sources
Author Date of Publication Title Date of Data Collection Data Source Sample Size Prevalence Data Stratified by:
Varma R, Choudhury F, et al. 2016 Prevalence and Causes of Visual Impairment and Blindness in Chinese American Adults: The Chinese American Eye Study 2010–2013 CHES 4,582 Race, Age, Sex
Fisher DE, Shraqer S, et al. 2015 Visual Impairment in White, Chinese, Black, and Hispanic Participants from the Multi-Ethnic Study of Atherosclerosis Cohort 2002–2004 MESA 6,134 Age, Sex, Race / Ethnicity
Maa AY, Evans C, et al. 2013 Veteran Eye Disease After Eligibility Reform: Prevalence and Characteristics January 2008–February 2008 Atlanta VA Medical Center Chart Review 658 Not stratified by demographic variables
Chou, C.F., Cotch, M.F., Vitale, S., et al. 2013 Age-Related Eye Diseases and Visual Impairment Among US Adults 2005–2008 NHANES 5,222 Age
Klein R, Lee KE, et al. 2009 Changes in Visual Impairment Prevalence by Period of Diagnosis of Diabetes: The Wisconsin Epidemiologic Study of Diabetic Retinopathy 1980–2007 WESDR Various Not stratified by demographic variables
Mansberger SL, Romero FC, et al. 2005 Causes of Visual Impairment and Common Eye Problems in Northwest American Indians and Alaska Natives Unknown Northwest AIAN 288 Not stratified by demographic variables
Varma R, Ying-Lai M, Klein R, Azen SP, et al. 2004 Prevalence and Risk Indicators of Visual Impairment and Blindness in Latinos: the Los Angeles Latino Eye Study. 2000–2008 LALES 6,122 Race / Ethnicity, Sex, Age
The Eye Diseases Prevalence Research Group 2004 Causes and Prevalence of Visual Impairment Among Adults in the United States 1985–1998 EDPRG Various Age, Race / Ethnicity, Sex
Muñoz B, West SK, Rodriguez J, et al. 2002 Blindness, Visual Impairment and the Problem of Uncorrected Refractive Error in a Mexican-American Population: Proyecto VER. 1997–1999 Proyecto VER 4,774 Age, Sex, Race / Ethnicity
Rubin GS, West S, et al. 1997 A Comprehensive Assessment of Visual Impairment in a Population of Older Americans. The SEE Study. Salisbury Eye Evaluation Project 1993–1995 The SEE Project 2,520 Age, Sex, Race
Rahmani B, Tielsch JM, et al. 1996 The Cause-Specific Prevalence of Visual Impairment in an Urban Population. The Baltimore Eye Survey 1985–1988 BES 5,300 Age, Sex, Race
Klein R, et al. 1995 The Relationship of Age-Related Maculopathy, Cataract, and Glaucoma to Visual Acuity 1988–1990 BDES 4,886 Age

Overall Vision Impairment and Blindness Prevalence Rates

Figure 1 shows the estimated total population prevalence rate for vision impairment derived from selected studies. Overall visual impairment prevalence rates ranged from 0.27% in MEPEDs to 7.5% in the 2005–2008 NHANES, which included older adults. Figure 2 reports blindness prevalence from selected studies. Overall, blindness prevalence rates ranged from 0.07% in CHES to 1.7% in the Atlanta VA Medical Center Chart Review. These studies identified and compared vision impairment and blindness prevalence rates across race/ethnicity, age, education level, and income.

The high degree of variation among the results in each figure is likely due to in part to methodological, disease definition, and population differences among the studies. These figures are intended to illustrate the range of published prevalence values; direct comparison of the studies is impossible without considering the underlying differences in the studies. Detailed results from each individual study are available in the full report “Published Examination-based Prevalence of Major Eye Disorders.”

Figure 1. Overall Vision Impairment Prevalence Rates in Selected Studies.

Table displays the following information in approximate percentages. CHES: 1.2 percent. MESA: 6.5 percent. VA Chart Review: 4.2 percent. 2005-5008 NHANES: 7.5 percent. MEPEDS: 4 percent. AIAN Vision Impairment Study: 3.1 percent. LALES: 3 percent. EDPRG: 2.8 percent. Proyecto VER: 1.8 percent. SEE: 3.5 percent. BES: 3 percent.

*Age- or population- adjusted prevalence rate.

Figure 2. Overall Blindness Prevalence Rates in Selected Studies**.

Table displays the following information in approximate percentages. CHES: 0.1 percent. VA Chart Review: 1.7 percent. AIAN Vision Impairment Study: 0.3 percent. LALES: 0.4 percent. EDPRG: 0.8 percent. Proyecto VER: 0.3 percent. SEE: 0.8 percent.

*Adjusted prevalence rate.
**Blindness is defined by the U.S. government definition of best-corrected visual acuity of 20/200 or worse.