WORLD VIEW Blindness and visual impairment in the Americas and the Caribbean

Aim: To summarise available data on the prevalence and causes of visual impairment and blindness in the Americas and the Caribbean. Methods: The published literature was searched in Medline and LILACS using the following key words: blindness, visual impairment, prevalence. Articles were reviewed, and the references of the articles were also searched for relevant articles, which were also reviewed. Results: Using the mortality in children under the age of 5 as an indicator, the overall prevalence of childhood blindness (in the under age 15 group) for the region was estimated at 0.45/1000, with the majority (67%) living in countries with mortality of children under age 5 above 30/1000 live births. Corneal opacities were more common in countries where the under 5 year mortality are above 30/1000 live births and retinopathy of prematurity (ROP) was an important cause in countries with intermediate death rates. For adults, overall blindness rates were not estimated because of the social, economic, and ethnic diversity in the region. The primary causes of visual loss in adults in the Americas were age related eye diseases, notably cataract and glaucoma in the African-American and Hispanic populations, and age related macular degeneration in the white population. Uncorrected refractive error was a significant cause of decreased vision across ages, ethnic groups, and countries. Conclusion: More data are needed on the magnitude and causes of visual loss for the Caribbean and Latin American countries. Rates of blindness and visual loss from available data within these countries are widely disparate. Prevention and control of avoidable blindness needs to be an ongoing focus in this region.