Visual function rather than visual acuity

We would like to express our gratitude Matthew Burton and colleagues for the Commission on Global Eye Health (April, 2021),1Burton MJ Ramke J Marques AP et al.The Lancet Health: vision beyond 2020.Lancet Glob Health. 2021; 9: 489-551Summary Full Text PDF PubMed Scopus (50) Google Scholar which highlights magnitude of challenge. As a plea we mention glaucomas. feel this preventable cause blindness has been insufficiently represented burden disease group understated because use visual acuity alone measure disability. Glaucomas result in loss function long before is affected, with field occurring first central disappearing last. This pattern means that many people will be blind by WHO definitions (visual less than 10°) but not have included data described if only considered. It telling consider why, despite this, glaucoma features as second leading yet hardly impairment (there no definition loss). In 2006, Afekhide Omoti colleagues2Omoti AE Osahon AI Waziri-Erameh Pattern presentation primary open-angle Benin City, Nigeria.Trop Doct. 2006; 36: 97-100Crossref (38) reported 154 patients Nigeria diagnosis at glaucoma. Of 119 presenting subjective loss, 38 (25%) were when using measure. A further 87 (57%) criteria, increasing proportion those 82%. study3Jones PR Philippin H Makupa WU Crabb DP Severity clinics England Tanzania.Ophthalmic Epidemiol. 2020; 27: 10-18Crossref (4) fields from newly diagnosed estimated effect size greater precision compared colleagues. underestimate unique glaucoma, another example being onchocerciasis.4Murdoch IE Jones BR Cousens S al.Visual constriction or impairment.Bull World Organ. 1997; 75: 141-146PubMed Although difficult quantify, existence additional should recognised. declare competing interests. The 2020Eye health widespread profound implications aspects life, health, sustainable development, economy. Yet nowadays, people, families, populations continue suffer consequences poor access high-quality, affordable eye care, blindness. Full-Text Open AccessVisual rather – Authors' replyWe thank Ian Murdoch David their important letter pointing out tendency global focusing solely loss. Glaucoma irreversible globally, whose share overall prevalence growing steadily investments begun pay off fight against diseases such cataract trachoma.1,2 Access