March 6, 2019
Krupa Philip, BOptom, PhD
Brien Holden Vision Institute
Uncorrected myopia as well as high myopia resulting in complications such as myopic macular degeneration (MMD) can potentially result in lost productivity. Such lost productivity has significant economic impact, and an estimate of lost productivity due to myopia is vital for evidence based advocacy, policy making and patient care. The economic impact of myopia related visual impairment (VI) and blindness has not been studied extensively.
A meta-analysis, modeling and systematic review of 37 studies from 36 countries (combined sample size; 174736 participants) was performed to identify the lost productivity associated with uncorrected myopia and MMD. Spectacle coverage data from all countries were analyzed against health and development indicators from each country. The effect of age and urbanization on spectacle coverage was also determined. Lost productivity due to VI and blindness from uncorrected myopia and MMD was estimated by the disability weight relevant to the level of impairment (mild VI, moderate VI, severe VI and blindness), age specific labor force participation rates, employment rates and gross domestic product (GDP) per capita in US dollars for 2015. Additionally, cost of care from an adult with normal vision for each individual with moderate VI, severe VI and blindness was also included in the calculation.
The researchers found that ‘older people in rural areas of least developed countries carry the greatest burden of VI resulting from uncorrected refractive error’. Potential productivity loss from VI associated with uncorrected myopia globally was estimated at US$244 billion and productivity loss from blindness associated with MMD was estimated at US$6 billion. Productivity loss significantly affected individuals in the age group 25 to 29 years. On the other hand, productivity loss was found to be distributed evenly across the working age group (15 to 64 year olds) when calculated in terms of US$ per capita. East Asia, South Asia and Southeast Asia were the regions significantly affected with lost productivity with productivity loss estimated at US$150 billion, US$40 billion and US$35 billion respectively.
These results suggest that potential productivity loss associated with VI and blindness as a result of uncorrected myopia and MMD is more than the cost of correcting myopia.
Potential Lost Productivity Resulting from the Global Burden of Myopia Systematic Review, Meta-analysis, and Modelling Kovin S. Naidoo, Timothy R. Fricke, Kevin D. Frick, Monica Jong, Thomas J. Naduvilath, Serge Resnikoff, Padmaja Sankaridurg
Purpose: We estimated the potential global economic productivity loss resulting from vision impairment (VI) and blindness as a result of uncorrected myopia and myopic macular degeneration (MMD) in 2015.
Clinical Relevance: Understanding the economic burden of VI associated with myopia is critical to addressing myopia as an increasingly prevalent public health problem.
Methods: We estimated the number of people with myopia and MMD corresponding to critical visual acuity thresholds. Spectacle correction coverage was analyzed against country-level variables from the year of data collection; variation in spectacle correction was described best by a model based on a human development index, with adjustments for urbanization and age. Spectacle correction and myopia data were combined to estimate the number of people with each level of VI resulting from uncorrected myopia. We then applied disability weights, labor force participation rates, employment rates, and gross domestic product per capita to estimate the potential productivity lost among individuals with each level and type of VI resulting from myopia in 2015 in United States dollars (US$). An estimate of care-associated productivity loss also was included.
Results: People with myopia are less likely to have adequate optical correction if they are older and live in a rural area of a less developed country. The global potential productivity loss associated with the burden of VI in 2015 was estimated at US$244 billion (95% confidence interval [CI], US$49 billioneUS$697 billion) from uncorrected myopia and US$6 billion (95% CI, US$2 billiondUS$17 billion) from MMD. Our estimates suggest that the Southeast Asia, South Asia, and East Asia Global Burden of Disease regions bear the greatest potential burden as a proportion of their economic activity, whereas East Asia bears the greatest potential burden in absolute terms.
Conclusions: Even under conservative assumptions, the potential productivity loss associated with VI and blindness resulting from uncorrected myopia is substantially greater than the cost of correcting myopia.
Source: Kovin S. Naidoo, Timothy R. Fricke, Kevin D. Frick, Monica Jong, Thomas J. Naduvilath, Serge Resnikoff, Padmaja Sankaridurg (2018). Potential Lost Productivity Resulting from the Global Burden of Myopia: Systematic Review, Meta-analysis, and Modeling. Ophthalmology [Article in press].