Reducing inequity of cataract blindness and vision impairment is a global priority, but where is the evidence?

Abstract

Throughout the world, people who are socially or economically disadvantaged disproportionately experience blindness and vision impairment caused by cataract. Reducing vision loss from cataract and its unequal distribution must be a priority if the WHO's aim of 'universal eye health' is to be realised. To help achieve this, decision-makers and service planners need evidence on which strategies improve access to cataract services among disadvantaged populations, and under what circumstances. Unfortunately, despite many strategies to improve cataract services being implemented in recent decades, evidence of what works, for who and in what circumstances is not readily available. This paper summarises the extent of the evidence on interventions to reduce inequity of vision loss from cataract and makes suggestions for how the evidence base can be strengthened.

Response to: Comment on: ‘The inverse-research law of global eye health’

“…What we advocate is that efforts are expended to identify effective, scalable and sustainable strategies-be they macro-economic, micro-economic, technological or administrative-that produce a CSR high enough, and sufficiently equitably accessible, to deal with incident cases of blinding cataract. This will require implementation research and health systems research along with strategies that address the maldistribution of human resources for eye health [5], integrate eye health into public health policy and financing arrangements, eliminate inequity [6], and improve quality.…”

Cochrane Eyes and Vision: a perspective introducing Cochrane Corner in Eye

“…Cochrane Eyes and Vision disseminates its reviews by working with guideline panels coordinated by NICE, American Academy of Ophthalmology, Royal College of Ophthalmologists and the College of Optometrists. We encourage review author teams copublish their Cochrane reviews in other journals [30] or write articles on the implications of the reviews [33]. We prepare a plain language summary for each review and a visual summary or blogshot (https://eyes.cochrane.org/blogshots ) along with other teaching materials, such as slidesets.…”

Evidence for national universal eye health plans

“…Unfortunately, little of this evidence exists for eye health in low- and middle-income countries. 30 – 32 Indeed, none of the countries cited a systematic review or any solution-based research to justify a policy approach or decision in their national plan ( Fig. 1 ).…”

“…Eye health research in low- and middle-income countries is likely to remain under-resourced, so it is essential that development partners, funders and researchers collaborate innovatively with countries to identify, generate and disseminate the most relevant evidence. 32 , 38 …”