Eye health services linked to advancing the Sustainable Development Goals

Study finds multiple interactions between improvements in eye care and international development

New research has shown that increasing the provision and quality of eye health services globally can contribute to the United Nations Sustainable Development Goals (SDGs), including those related to overall health, poverty, economic productivity, education and equality.

The review, published in The Lancet Planetary Health, assessed 226 existing papers in relation to eye health and the targets of the United Nations SDG programme, discovering direct and indirect links across all of the goals.

1.1 billion people were living with untreated vision impairment in 2020, and this is expected to grow to 1.8 billion by 2050. Despite progress in recent years against certain infectious diseases, millions continue to live with impaired vision and blindness unnecessarily. Ninety per cent of people living with these conditions live in low and middle-income countries, and vision impairment disproportionately affects women, rural populations, and ethnic minority groups.

This research, carried out as part of the Lancet Global Health Commission on Global Eye Health, looked at studies that reported the relationship between an eye health service and outcomes or pathways related to the SDGs. These services included cataract surgery, free cataract screening, provision of spectacles, trichiasis surgery, rehabilitation services, and rural community eye health volunteers.

The authors found multiple direct connections between eye health services and the SDGs, including:

• Improved eye health reduces poverty (SDG 1) and improves productivity (SDG 8)

Several studies have shown increases in productivity, household expenditure and household income following the introduction of eye health interventions. For example, in the Philippines, household per capita expenditure increased by 88% over one year in people who underwent cataract surgery.

• Improved eye health advances general health and well-being (SDG 3)

Reviews complementary to this study have shown associations between vision impairment and mortality, falls, quality of life, dementia, mental health, cardiovascular disease, respiratory disease and cancer.

• Improved eye health advances educational outcomes (SDG 4)

Good vision is associated with improved educational outcomes. The provision of spectacles can improve academic test scores, with one study in China showing that the provision of spectacles reduced the odds of failing a class by 44%.

• Improved eye health advances equality (SDGs 5 & 10)

Interventions such as training rural community eye health volunteers and provision for cataract surgery can reduce gender inequality in relation to attendance and treatment. Similarly, income equality has been shown to be improved through cataract surgery.

• Improved eye health reduces road traffic accidents (SDG 11)

Cataract has been found to increase the odds of being involved in a collision by 2.5x. Studies have shown that cataract surgery can reduce driving-related difficulties and motor vehicle crashes.

Overall, 27 studies reported that eye health services had a positive effect on advancing one or more SDG targets, with indirect effects proposed for all further goals. Cataract surgery and spectacles were the interventions with the largest number of reported beneficial effects on an SDG.

Professor Matthew Burton, Director of the ICEH at LSHTM, said: “This research is one of only two studies looking at the connections between improvements in a specific area of health and the SDGs. The work highlights both the direct and indirect effects of improving eye health on advancing multiple SDGs, showing that eye health is a powerful enabling tool for sustainable development. However, eye health does not currently feature within any of the many targets and indicators of SDG monitoring. There is now an evidence base to embed eye health policies across education, the workplace and social services, with interventions receiving the appropriate political prioritization and financial support that a challenge of this scale deserves.”

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Image on top: Using a magnifier to read clearly/Photo by FROILAND RIVERA