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Health and healthcare disparities for surgical patients with blindness and low vision (pBLV) stem from inaccessible healthcare systems that lack universal design principles or, at a minimum, reasonable accommodations (RA). We aimed to identify barriers to developing and implementing RAs in the surgical setting and provide a review of best practices for providing RAs. We conducted a search of PubMed for evidence of reasonable accommodations, or lack thereof, in the surgical setting. Articles related to gaps and barriers to providing RAs for pBLV or best practices for supporting RAs were reviewed for the study. Barriers to the implementation of reasonable accommodations, and, accordingly, best practices for achieving equity for pBLV, relate to policies and systems, staff knowledge and attitudes, and materials and technology. These inequities for pBLV require comprehensive frameworks that offer, maintain, and support education about disability disparities and RAs in the surgical field. Providing RAs for surgical pBLV, and all patients with disabilities is an important and impactful step towards creating a more equitable and anti-ableist health system. •Reasonable accommodations (RA) are adjustments in policies, practices and procedures to ensure accessibility for all patients.•The lack of comprehensive frameworks for supporting RAs leads to health disparities for people with blindness and low vision.•Barriers to providing RAs can be categorized as related to policies and systems, staff and attitudes, or materials.

Assistive technologies can enhance safety, independence, and quality of life for people with blindness and low vision. Despite their benefits, abandonment of these technologies remains widespread, and recent research on this issue is limited. In this Perspective article, we draw on both professional experiences and relevant scientific literature to examine adoption and abandonment in the context of new artificial intelligence-powered applications. We highlight risks arising from misaligned design, inconsistent industry support, and inadequate user training. We synthesize existing knowledge on factors that influence abandonment and propose three priorities to realign assistive technology development: participatory and transdisciplinary research, integrated technology ecosystems, and socially supported engagement. Taken collectively, these priorities ensure that emerging assistive technologies better align with the needs of people with blindness and low vision, promoting lasting adoption rather than abandonment.

Background Age-related macular degeneration (AMD) is a leading cause of blindness and low vision worldwide. This study examines the global burden and trends in AMD-related low vision and blindness from 1990 to 2021, with projections through 2050. Methods Data were obtained from the 2021 Global Burden of Disease (GBD 2021) study, covering 204 countries and regions. Key metrics, including the prevalent case numbers, annual disability-adjusted life years (DALYs), age-standardized prevalence rates (ASPR), and age-standardized DALY rates (ASDALYR), specific to low vision and blindness due to AMD, were calculated per 100,000 population. Trend analysis used the estimated annual percentage change (EAPC) method, and K-means clustering identified regions with similar burdens and trends. Autoregressive Integrated Moving Average(ARIMA) and Exponential Smoothing(ES) models provided future projections. Results Globally, the total number of prevalent cases and DALYs has substantially increased. The number of prevalent cases of low vision and blindness due to AMD increased from 3,640,180 (95% UI: 3,037,098 − 4,353,902) in 1990 to 8,057,521 (95% UI: 6,705,284-9,823,238) in 2021. DALYs increased from 302,902 (95% UI: 206,475 − 421,952) in 1990 to 578,020 (95% UI: 401,241–797,570) in 2021. From 1990 to 2021, both the ASPR and ASDALYR for AMD-related low vision and blindness showed a downward trend. The ASPR was 94 (95% UI: 78.32-114.42) per 100,000 population, with an EAPC of -0.26 (95% CI: -0.31 to -0.22), and the ASDALYR was 6.78 (95% UI: 4.7–9.32) per 100,000 population, with an EAPC of -0.94 (95% CI: -1.01 to -0.88). The disease burden of AMD-related low vision and blindness increases with age, and the burden for female patients is slightly higher than for males. Regional stratification by the Socio-Demographic Index (SDI) shows that the burden of AMD-related low vision and blindness in areas with low SDI is higher than in areas with high SDI. From 1990 to 2021, notable increases in ASPR and ASDALYR were observed mainly in the southern and central regions of sub-Saharan Africa. Moreover, the increases in prevalence and DALYs vary by region, country, and level of socioeconomic development. The ARIMA model predicts that by 2050, the number of prevalent cases of low vision and blindness due to AMD will reach 13,880,610(95% CI: 9,805,575–17,955,645), and the DALYs will be 764,731(95% CI: 683,535–845,926). The ES model predicts that by 2050, the number of prevalent cases of AMD-related low vision and blindness will reach 9,323,124(95% CI: 5,222,474–13,423,774), and the DALYs will be 641,451 (95% CI: 383,588–899,318). Conclusion This study indicates that between 1990 and 2021, the global prevalent cases and DALYs caused by AMD-related low vision and blindness have increased over the past three decades, correlating with factors such as age, gender, socioeconomic status, and geographical location. Predictive models indicate that as the population ages, the number of patients with low vision and blindness due to AMD, along with associated DALYs, will continue to rise. By 2050, it is expected that over 9 million people worldwide will be affected by AMD-related vision loss, with women being particularly impacted. These findings can provide data support for public health planning, resource allocation, and the formulation of medical policies, ensuring an effective response to the challenges posed by the future increase in AMD-related low vision and blindness.

Background Low vision and blindness are major public health problems. A vast burden of worlds visually impaired live in low-income settings especially in sub Saharan Africa. In such settings the blindness is associated with considerable disability and excess mortality, resulting in huge economic and social consequence. The main purpose of this study was to determine the prevalence and associated factors of low vision and blindness among patients at St. Paul’s hospital millenium medical college. Methods Institution based cross sectional design study was carried out from January to April, 2017 with sample size of 904. Systematic random sampling was used to recruit the study subjects. Retrospective medical chart review was done; data was entered into and analyzed by SPSS 23. Descriptive statistics such as frequency cross tabulation and chi-square test was carried out to translate data into information. P -value less than 0.05 was considered as statistically significant. Results A total of 881 subjects with a response rate of 97.4% selected. The mean age of the study subjects was 44.53(SD: ± 21.85) with a range of 1–100 years. The prevalence of low vision and blindness was 91 (10.3% (95% CI: 8.2, 12.3)), and 64 (7.3 95%CI: 5.7, 9.0)) respectively. Age ( p -value < 0.001), cataract ( p -value = 0.002), glaucoma ( p -value = 0.002) and age related macular degeneration ( p -value < 0.001) were significantly associated with low vision and blindness. Conclusion Low vision and blindness found in this study was high. Age, cataract, glaucoma and age related macular degeneration were significantly associated with low vision and blindness. This amount of magnitude will be reduced if prevention, early diagnosis and management will be targeted towards avoidable causes of visual impairment.

A recent review of the causes and prevalence of low vision and blindness world wide is lack-ing. Such review is important for highlighting the causes and prevalence of visual impairment in the different parts of the world. Also, it is important in providing information on the types and magnitude of eye care programs needed in different parts of the world. In this article, the causes and prevalence of low vision and blind-ness in different parts of the world are reviewed and  the  socio-economic  and  psychological implications are briefly discussed. The review is based on an extensive review of the litera-ture using computer data bases combined with review of available national, regional and inter-national journals. Low vision and blindness are more prevalent in the developing countries than in the developed ones. Generally, the causes and prevalence of the conditions vary widely in different parts of the world and even within the same country. World wide, cataract is the most common cause of blindness and low vision among adults and elderly. Infectious diseases such as trachoma and onchocerciasis result-ing in low vision and blindness are peculiar to Africa, Asia and South America. Hereditary and congenital conditions are the most common causes of low vision and blindness among chil-dren worldwide.

Estimates of the prevalence and causes of visual impairment in South Africa are reviewed against the existing services and limitations in the country. The magnitude1 of visual impair-ment  and  the  projected  increase  worldwide over the coming decades have been recognized as having potentially far-reaching social, eco-nomic and quality of life implications for not only the affected individuals but also for their families and communities. Two-thirds or more of all blindness is avoidable, in that the causes are  preventable  or  treatable.2,  3  Early  detec-tion, prevention and management programs are needed to reduce the impact of visual impair-ment. Approximately 80% of the South African population is indigent, relying on public hospi-tals and clinics and the remaining 20% of the population has access to private health care.4 As the majority of eye care professionals are in private practice, access to eye care services are available to only a minority of the population. This paper reviews the current services in South Africa and the challenges that lie ahead.

AimFrom the most recent data the magnitude of visual impairment and its causes in 2010 have been estimated, globally and by WHO region. The definitions of visual impairment are the current definitions of presenting vision in the International Classification of Diseases version 10.MethodsA systematic review was conducted of published and unpublished surveys from 2000 to the present. For countries without data on visual impairment, estimates were based on newly developed imputation methods that took into account country economic status as proxy.ResultsSurveys from 39 countries satisfied the inclusion criteria for this study. Globally, the number of people of all ages visually impaired is estimated to be 285 million, of whom 39 million are blind, with uncertainties of 10–20%. People 50 years and older represent 65% and 82% of visually impaired and blind, respectively. The major causes of visual impairment are uncorrected refractive errors (43%) followed by cataract (33%); the first cause of blindness is cataract (51%).ConclusionThis study indicates that visual impairment in 2010 is a major health issue that is unequally distributed among the WHO regions; the preventable causes are as high as 80% of the total global burden.

To assess the number of individuals visually impaired or blind due to glaucoma and to examine regional differences and temporal changes in this parameter for the period from 1990 to 2012. As part of the Global Burden of Diseases (GBD) Study 2010, we performed a systematic literature review for the period from 1980 to 2012. We primarily identified 14,908 relevant manuscripts, out of which 243 high-quality, population-based studies remained after review by an expert panel that involved application of selection criteria that dwelt on population representativeness and clarity of visual acuity methods used. Sixty-six specified the proportion attributable to glaucoma. The software tool DisMod-MR (Disease Modeling-Metaregression) of the GBD was used to calculate fraction of vision impairment due to glaucoma. In 2010, 2.1 million (95% Uncertainty Interval (UI):1.9,2.6) people were blind, and 4.2 (95% UI:3.7,5.8) million were visually impaired due to glaucoma. Glaucoma caused worldwide 6.6% (95% UI:5.9,7.9) of all blindness in 2010 and 2.2% (95% UI:2.0,2.8) of all moderate and severe visual impairment (MSVI). These figures were lower in regions with younger populations (<5% in South Asia) than in high-income regions with relatively old populations (>10%). From 1990 to 2010, the number of blind or visually impaired due to glaucoma increased by 0.8 million (95%UI:0.7, 1.1) or 62% and by 2.3 million (95%UI:2.1,3.5) or 83%, respectively. Percentage of global blindness caused by glaucoma increased between 1990 and 2010 from 4.4% (4.0,5.1) to 6.6%. Age-standardized prevalence of glaucoma related blindness and MSVI did not differ markedly between world regions nor between women. By 2010, one out of 15 blind people was blind due to glaucoma, and one of 45 visually impaired people was visually impaired, highlighting the increasing global burden of glaucoma.

Avoidable blindness is a significant public health problem in India. Nationally representative RAAB surveys (Rapid Assessment of Avoidable Blindness) are being conducted periodically in the country to know the current status of blindness in the country. The current study describes the findings from the RAAB survey conducted during 2015-19 in India. A cross-sectional, population-based survey was conducted across the entire country among persons aged 50 years and above using RAAB version 6 methodology. Presenting and pinhole visual acuity was recorded followed by lens examination using a torchlight. In order to estimate the prevalence of blindness and visual impairment in overall population in India, district weights were assigned to each of the 31 surveyed districts and the prevalence was standardized using the RAAB software. The overall weighted, age-gender standardized, prevalence of blindness (presenting visual acuity <3/60 in better eye) in population aged ≥50 years was 1.99% (95% CI 1.94%, 2.13%) and of visual impairment (VI) (presenting visual acuity <6/12 in better eye) was 26.68% (95% CI 26.57-27.17%). On multivariate analysis, adjusted odds ratio showed that blindness was associated with age ≥ 80 years (OR = 20.3, 95% CI: 15.6-26.4) and being illiterate (OR = 5.6, 95% CI: 3.6-8.9). Blindness was not found to be significantly associated with either gender or locality. The results of the survey demonstrate that currently more than one fourth of persons aged 50 years and above are visually impaired (PVA<6/12 in better eye) in India. The prevalence of blindness among them is 1.99%, and older age and illiteracy are significantly associated with blindness. Major causes of blindness included cataract (66.2%), corneal opacity (CO) (8.2%), cataract surgical complications (7.2%), posterior segment disorders (5.9%) and glaucoma (5.5%). The proportion of blindness and visual impairment that is due to avoidable causes include 92.9% and 97.4% respectively.

The incidence of high myopia is increasing worldwide with myopic maculopathy, a complication of myopia, often progressing to blindness. Our two-stage genome-wide association study of myopic maculopathy identifies a susceptibility locus at rs11873439 in an intron of CCDC102B ( P  = 1.77 × 10 −12 and P corr  = 1.61 × 10 −10 ). In contrast, this SNP is not significantly associated with myopia itself. The association between rs11873439 and myopic maculopathy is further confirmed in 2317 highly myopic patients ( P  = 2.40 × 10 −6 and P corr  = 1.72 × 10 −4 ). CCDC102B is strongly expressed in the retinal pigment epithelium and choroids, where atrophic changes initially occur in myopic maculopathy. The development of myopic maculopathy thus likely exhibits a unique background apart from the development of myopia itself; elucidation of the roles of CCDC102B in myopic maculopathy development may thus provide insights into preventive methods for blindness in patients with high myopia. Myopic maculopathy is a complication of myopia that often progresses to blindness. Here, in a genome-wide association study, Hosoda et al. find that rs11873439 intronic to CCDC102B is associated with myopic maculopathy, but not with myopia, thus representing a risk factor independent of myopia.