The Amenable Vision Loss Index: How Well Are Eye Care Systems Preventing Blindness and Distance Vision Loss

Abstract

The Amenable Vision Loss Index was created as a tool for evaluating eye care systems by measuring their ability to reduce disease burden due to two causes of blindness and distance vision loss: uncorrected refractive error and cataract. Separate indices for cataract and uncorrected refractive error measured the ability of health systems to address the disease burden due to each cause. The Amenable Vision Loss Index was made by combining risk-standardized, age-standardized, and severity-weighted prevalence of uncorrected refractive error and cataract into one index score. The Cataract Index and Uncorrected Refractive Error Index were formulated using the same methods. In 2016, Sweden, Canada, and the USA had the best Amenable Vision Loss Index scores and Myanmar, Cambodia, and Timor-Leste had the worst scores. The correlation between the Amenable Vision Loss Index and the Socio-Demographic Index (SDI) was lower than expected a priori; the r-squared was 0.4. In general, index scores improved between 1990 and 2016, though improvement was not ubiquitous. Improvements in Amenable Vision Loss Index scores between 1990 and 2016 were modest and improvements in Cataract Index scores were minimal: 12.78% (8.52% to 16.83%) and 2.85% (-7.8% to 14.26%), respectively. The UREI saw the largest improvement at 17.89% (15.74% - 20.32%).