Keeping an eye on eye care: monitoring progress towards effective coverage

A new paper published in Lancet Global Health provides further details on the development of the ambitious global eye health targets (cataract and refractive error eye care indicators) recently endorsed by WHO Member States at the 74th World Health Assembly in May, 2021.

The authors explain that these two indicators were selected as they serve as a reasonable proxy for the overall status of eye care services, can provide information on different segments of the population, are based on cost-effective interventions, are likely to reflect health system factors and are feasibly monitored in many countries. 

The authors highlight that the ability to collect and monitor data in a standardised manner is crucial for achieving the global targets and provide further detail on the calculations for eREC. 

Importantly, this paper provides further definition on the thresholds for defining good vision and good vision outcomes following cataract surgery or receiving spectacles. “Based on a growing body of evidence that mild vision impairment has notable impacts on the everyday functioning of individuals”, the global reporting framework will use a best-corrected visual acuity (BCVA) of 6/12 or better. This also means that the definition of ‘vision-impairing cataract’ uses the same 6/12 threshold, although the authors point out that this is contingent on a range of factors such as patients’ felt need for surgery, and a country’s capability for surgery.  

Finally the authors discuss some of the efforts underway to help widespread data collection across all relevant target populations.  

Publication:  

Keel, S., Müller, A., Block, S., Bourne, R., Burton, M. J., Chatterji, S., He, M., Lansingh, V. C., Mathenge, W., Mariotti, S., Muirhead, D., Rabiu, M., Ravilla, T. D., Resnikoff, S., Silva, J. C., Tapply, I., Vos, T., Wang, N., & Cieza, A. (2021). Keeping an eye on eye care: monitoring progress towards effective coverage. The Lancet Global Health. https://doi.org/10.1016/S2214-109X(21)00212-6 

Image on top: Test after the cataract operation/Lia Marmelstein