WHO Exposes Global Refraction GapLess than half the people over 50 worldwide have the spectacles or contact lenses they need to correct refractive error, according to new research informing a major World Health Organization (WHO) report on eye care. The study also highlighted a gender gap in all defined regions of the world, with lower levels of treatment coverage in women. Uncorrected refractive error, such as presbyopia, myopia, hyperopia, and astigmatism, is the world’s most common visual complaint, affecting at least 157 million people in 2020. The new study, carried out by the Vision Loss Expert Group, led by Professor Rupert Bourne, of Anglia Ruskin University (ARU) and Cambridge University Hospitals, was published in The Lancet Global Health and presented to the United Nations in October. Researchers analysed data from 169 different studies from across the world to calculate figures in several defined regions for treatment coverage of distance and near refractive error. While adequate treatment coverage of distance refractive error – conditions such as myopia, astigmatism, or moderate to severe hyperopia – had increased by 19% since 2000, only 43% of all adults over the age of 50 are receiving simple treatments for these conditions. Only 21% of people with presbyopia have adequate treatment coverage. Treatment coverage for distance refractive error varied worldwide, from 79% in the defined ‘high income’ region, to just 5.7% in Sub-Saharan Africa. The WHO aims to increase the treatment coverage for distance refractive error by 40 percentage points by 2030. “There are multiple social and cultural reasons that influence coverage of treatment for refractive error,” Professor Bourne said. “Of these, the lower coverage among women is most striking. We believe that differences in access to healthcare and take-up of services are likely to be the main reasons for this gender inequality.” The research was funded by the WHO and several other eye care organisations, including The Fred Hollows Foundation and Brien Holden Vision Institute.