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Magnitude and Projections

Child eye health

Vision loss can significantly impact a child’s ability to learn and have ongoing consequences for their life opportunities.

Magnitude of vision loss in children and adolescents

Globally, at least 450 million children have a sight condition that needs treatment, with 90 million children living with some form of sight loss.

  • 448 million children and adolescents have refractive errors.1,2
  • 90 million children and adolescents live with sight loss.3

The prevalence of vision loss in children varies considerably within, and between countries and regions.

However, if refractive error is excluded, the number of children who are blind from eye conditions is falling in all regions,4 due to the reduction of corneal blindness due to vitamin A deficiency and measles.

Two boys having their eye screened with portable equipment

Impact of vision loss in children and adolescents

Vision impairment in children can severely impact educational outcomes,5–9 contribute to low self-esteem10 and future socio-economic potential.11

The Lancet Global Health Commission on Global Eye Health12 reported that children with vision loss in low- and middle-income countries are up to five times less likely to be in formal education.13

Malik et al.14 reported that children who are blind are more likely to die in childhood than a child with good vision, especially in low-income countries.

A girl wearing a brilliant blue school uniform in front of the same coloured background

Causes of vision loss in children

Data on vision impairment in children and adults younger than 40 years are scarce.12 However, among children the leading causes of blindness and moderate-severe vision impairment include uncorrected refractive error, cataract, retinopathy of prematurity, congenital ocular anomalies, corneal scarring, and cerebral visual impairment.12

Refractive errors, particularly myopia, are a leading and increasing cause of visual impairment and blindness in children.15, 16

The prevalence of myopia in children and adolescents is rapidly increasing in many parts of the world,17 due to lifestyle changes for children. In 2020, 60% of children in Asia and 40% of children in Europe had myopia.18

A boy who is blind due to corneal opacity reading Braille

Solutions for vision loss in children

It is estimated that 40% of children are blind from eye conditions that could have been prevented or could be managed if the child had access to eye care services.19

To improve child eye health and reduce disability, comprehensive services are needed at community, primary, secondary, and tertiary level.4

The Lancet Commission12 reported spectacles to be one of the most effective health interventions for children, reducing the chance of failing a class by 44%.7

School-based eye health programmes offer an effective,20-22 cost-effective model to deliver eye care to schoolchildren,23,24 and are efficient in respect to time and resources.25

A young girl wearing an eye patch being held by a man after cataract surgery

Find out more

Read more about child eye health in A Situational Analysis of Child Eye Health (2016).

School eye health guidelines are also available.

Notes

  • Children and adolescents are those aged 0-19 years.
  • 448 million children and adolescents have refractive errors:  This is comprised of 339.4 million with myopia ≤-0.75D in 2020,1 and 109.3 million with vision impairing hyperopia in 2020.2 These numbers have been provided directly by the authors and are rounded to 450 million.
  • 90 million children and adolescents live with sight loss: this is comprised of 2 million with blindness, and 30 million with moderate to severe sight loss and 58 million with mild sight loss.3
  • In children aged 0-14 years, there are 1.4 million children with blindness, 22.6 million children with moderate to severe sight loss and 46.6 million children with mild sight loss.12
  • The two numbers (448 million and 90 million) can’t be added together, as they are counting different things, and we do not know the crossover between the two groups. We do not know how many of the 448 million have the glasses/contact lenses that they need, we also do not know how much of the sight loss experienced by the 90 million children is due to uncorrected refractive errors.

 

  1. Holden BA, Fricke TR, Wilson DA, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology 2016;123:1036–42. doi:10.1016/j.ophtha.2016.01.006
  2. Castagno VD, Fassa AG, Carret MLV, et al. Hyperopia: A meta-analysis of prevalence and a review of associated factors among school-aged children. BMC Ophthalmology 2014;14. doi:10.1186/1471-2415-14-163
  3. Bourne R, Steinmetz JD, Flaxman S, et al. Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study. The Lancet Global Health Published Online First: 5 January 2021. doi:10.1016/S2214-109X(20)30425-3
  4. Gilbert C, Bowman R, Malik AN. The epidemiology of blindness in children: changing priorities. Community Eye Health. 2017;30(100):74.
  5. Glewwe P, West KL, Lee J. The Impact of Providing Vision Screening and Free Eyeglasses on Academic Outcomes: Evidence from a Randomized Trial in Title I Elementary Schools in Florida. J Policy Anal Manage. 2018;37(2):265–300.
  6. Glewwe P, Park A, Zhao M. A better vision for development: Eyeglasses and academic performance in rural primary schools in China. Journal of Development of Economics. 2016 Sep 1;122:170–82.
  7. Hannum E, Zhang Y. Poverty and Proximate Barriers to Learning: Vision Deficiencies, Vision Correction and Educational Outcomes in Rural Northwest China. World Dev. 2012 Sep 1;40(9):1921–31.
  8. Ma X, Zhou Z, Yi H, Pang X, Shi Y, Chen Q, et al. Effect of providing free glasses on children’s educational outcomes in China: cluster randomized controlled trial. BMJ. 2014 Sep 23;349:g5740.
  9. Ma Y, Congdon N, Shi Y, Hogg R, Medina A, Boswell M, et al. Effect of a Local Vision Care Center on Eyeglasses Use and School Performance in Rural China: A Cluster Randomized Clinical Trial. JAMA Ophthalmol. 2018 Jul 1;136(7):731–7.
  10. Rainey L, Elsman EBM, van Nispen RMA, van Leeuwen LM, van Rens GHMB. Comprehending the impact of low vision on the lives of children and adolescents: a qualitative approach. Qual Life Res. 2016 Oct;25(10):2633–43.
  11. Schneider J, Leeder SR, Gopinath B, Wang JJ, Mitchell P. Frequency, course, and impact of correctable visual impairment (uncorrected refractive error). Surv Ophthalmol. 2010 Dec;55(6):539–60.
  12. Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, et al. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020. The Lancet Global Health. 2021 Apr;9(4):e489–551.
  13. Kuper H, Dok AM, Wing K, Danquah L, Evans J, Zuurmond M, et al. The Impact of Disability on the Lives of Children; Cross-Sectional Data Including 8,900 Children with Disabilities and 898,834 Children without Disabilities across 30 Countries. PLOS ONE. 2014 Sep 9;9(9):e107300.
  14. Malik ANJ, Mafwiri M, Gilbert C. Integrating primary eye care into global child health policies. Arch Dis Child. 2018 Feb;103(2):176–80.
  15. Gilbert C, Vijayalakshmi P, Bhaskaran S, Udupihille T, Muhiddin HS, Windy DA, et al. Childhood Blindness and Visual Impairment. In: Das T, Nayar PD, editors. South-East Asia Eye Health: Systems, Practices, and Challenges [Internet]. Singapore: Springer Singapore; 2021. p. 169–95. Available from: https://doi.org/10.1007/978-981-16-3787-2_11
  16. Naidoo KS, Jaggernath J. Uncorrected refractive errors. Indian J Ophthalmol. 2012;60(5):432–7.
  17. Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, Wong TY, Naduvilath TJ, Resnikoff S. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016 May 1;123(5):1036-42.
  18. Grzybowski A, Kanclerz P, Tsubota K, Lanca C, Saw SM. A review on the epidemiology of myopia in school children worldwide. BMC ophthalmology. 2020 Dec;20(1):1-1.
  19. Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, et al. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020 [Supplementary appendix 1]. The Lancet Global Health. 2021 Apr;9(4):e489–551.
  20. Evans JR, Morjaria P, Powell C. Vision screening for correctable visual acuity deficits in school-age children and adolescents. Cochrane Database Syst Rev. 2018 Feb 15;2:CD005023.
  21. Rono HK, Bastawrous A, Macleod D, Wanjala E, Tanna GLD, Weiss HA, et al. Smartphone-based screening for visual impairment in Kenyan school children: a cluster randomised controlled trial. The Lancet Global Health. 2018 Aug 1;6(8):e924–32.
  22. Sheeladevi S, Seelam B, Nukella PB, Modi A, Ali R, Keay L. Prevalence of refractive errors in children in India: a systematic review. Clinical and Experimental Optometry. 2018 Jul 1;101(4):495–503.
  23. Frick KD, Riva-Clement L, Shankar MB. Screening for refractive error and fitting with spectacles in rural and urban India: cost-effectiveness. Ophthalmic Epidemiol. 2009 Dec;16(6):378–87.
  24. Wodon, Q., Male, C., Nayihouba, A., & Smith, E. (2019). Looking Ahead: Visual Impairment and School Eye Health Programs.
  25. Minto H, Ho M. What is comprehensive school eye health? Community Eye Health Journal. 2017 Sep 1;30:21–5.

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