Millions worldwide continue to suffer from uncorrected refractive error, underscoring a persistent global health challenge that demands urgent attention. A comprehensive new study, led by Professor Rupert Bourne of Anglia Ruskin University, brings to light sobering statistics regarding the availability and quality of eye care services related to vision correction. Despite advances in optical technology and public health initiatives, the global effective refractive error coverage (eREC), a metric representing the proportion of individuals receiving appropriate prescriptions and wearing corrective glasses, stands at just 65.8%. This stagnation—only a modest 6 percentage point increase since 2010—highlights a growing gap between needs and access.
Published in the prestigious journal The Lancet Global Health, the study synthesizes data from over 815,000 individuals spanning 76 countries, encompassing a variety of socio-economic and geographic contexts. The research scrutinizes disparities not only between nations of varying income levels but also focuses on vulnerable demographics including women, the elderly, and residents of low-income regions. By stratifying the data into seven super-regions, the analysis exposes glaring inequities: in wealthy regions such as North America and Western Europe, including the UK, eREC exceeds 80%, whereas in Sub-Saharan Africa, coverage languishes below 30%. Such variation points to systemic disparities in healthcare infrastructure and affordability.
The significance of uncorrected refractive error, which often manifests as myopia, hyperopia, or astigmatism, extends far beyond visual impairment. This condition, when left uncorrected, precipitates a cascade of socio-economic consequences ranging from reduced productivity and educational setbacks to increased poverty and social exclusion. Professor Bourne articulates that correcting refractive errors represents among the most cost-effective interventions in global health. Unlike surgical treatments or pharmacological approaches, prescribing and distributing spectacles is relatively inexpensive and scalable, yet remains insufficiently deployed.
One of the most alarming conclusions is that, despite the World Health Organization (WHO) establishing an ambitious goal in 2021 to increase eREC coverage by 40 percentage points by 2030, current trajectories predict that this target will be missed. The WHO’s framework emphasizes country-specific targets calibrated to economic and epidemiological conditions, with high-income countries expected to achieve near-universal coverage by the deadline. However, the current pace of improvement is insufficient to close the coverage gap globally, especially in regions burdened with inadequate health infrastructure.
The factors influencing this persistent shortfall are multifaceted. While the number of individuals receiving the correct prescription for eyeglasses improved by approximately 50% between 2000 and 2023, this gain is overshadowed by an accelerated increase in refractive error prevalence. Lifestyle changes—such as escalating screen time among children and diminished outdoor activities—have contributed substantially to rising myopia rates, effectively increasing the global need for corrective lenses. This epidemiological trend challenges health systems to scale interventions rapidly while maintaining quality and equity.
Regional case studies illuminate policy approaches with promising outcomes. France, for instance, introduced a full reimbursement policy for spectacles under its universal health insurance reforms in 2021/22, significantly lowering financial barriers and driving up spectacle uptake. Similarly, Pakistan’s national eye-care strategies implemented over the last two decades have demonstrated measurable improvements in spectacle usage and subsequent reductions in vision-related disability. These examples underscore the impact of systemic policy interventions in expanding access to basic refractive care.
The study’s methodology, rooted in systematic review and meta-analysis, incorporated rigorous population-based survey data, enabling robust cross-national comparisons and modeling of future coverage pathways. Such an evidence-based approach emphasizes data harmonization and standardization, critical for defining and tracking eREC progress in line with international targets. Moreover, by engaging a global network—the Vision Loss Expert Group—this research leverages multidisciplinary expertise, integrating ophthalmology, public health, and policy analysis.
Beyond epidemiology, the economic dimension of uncorrected refractive error bears consideration. Visual impairment arising from untreated refractive errors imposes quantifiable costs on healthcare systems, employers, and societies at large. Loss in productivity and increased dependency place a disproportionate burden on low- and middle-income countries where optical services are often scarce or prohibitively expensive. Addressing this unmet need is not only a moral imperative but also an economically strategic intervention.
Technological innovations could play a pivotal role in bridging the accessibility gap. Advances in low-cost autorefractors, smartphone-based vision screening tools, and distribution models incorporating community health workers offer scalable solutions adaptable to resource-poor settings. Integrating these innovations within primary healthcare and eye-care systems promises to accelerate diagnostic accuracy and spectacle provision, overcoming logistical and infrastructural constraints.
Funded by prominent organizations including the World Health Organization, Sightsavers International, the Fred Hollows Foundation, Fondation Thea, University of Heidelberg, and the German Federal Ministry for Education and Research, this study reflects a concerted global commitment to confronting vision health disparities. The collaborative effort underscores an emerging consensus around refractive error correction as a public health priority necessitating integrated interventions across health policy, finance, education, and technology sectors.
Professor Bourne’s call to action resonates with urgency: without rapid and sustained investment, the 2030 target envisaged by the WHO will remain an unattainable ambition, perpetuating avoidable vision loss and its broader societal consequences. The study advocates for comprehensive strategies incorporating policy reform, health insurance coverage expansion, community-based screening, and health education campaigns targeted towards high-risk populations, particularly women and older adults in underserved regions.
In conclusion, the persistent low coverage of effective refractive error correction—a condition easily addressed yet frequently neglected—represents a critical global health challenge of the 21st century. Bridging this gap requires bold policy innovation, cross-sector collaboration, and leverage of emerging technologies. Such endeavors promise to transform lives, enhance equity, and unlock untapped human potential worldwide by restoring a simple yet fundamental human sense: clear vision.
Subject of Research: Uncorrected refractive error coverage and global eye care accessibility
Article Title: Effective refractive error coverage in adults: a systematic review and meta-analysis of updated estimates from population-based surveys in 76 countries modelling the path towards the 2030 global target
News Publication Date: 22-May-2025
Web References:
- WHO Specs 2030 Initiative: https://www.who.int/news-room/events/detail/2024/05/14/default-calendar/launch-of-the-who-specs-2030-initiative–including-the-inaugural-meeting-of-the-global-specs-network#:~:text=In%20recognition%20of%20the%20large,members%2C%20and%20b)%20Secretariat.
- Anglia Ruskin University – Professor Rupert Bourne: https://www.aru.ac.uk/people/rupert-bourne
