Although the number of affected individuals increased for blindness due to all modelled causes, age-standardised prevalence for all modelled causes of vision except diabetic retinopathy has decreased over the past three decades. Age-standardised prevalence was higher in women than in men for all modelled causes of moderate or worse vision impairment, with the exception of glaucoma for which age-standardised prevalence was higher in men. Although less easily treatable, glaucoma, diabetic retinopathy, and age-related macular degeneration collectively led to more than 19 million cases of moderate or worse vision impairment in adults aged 50 years and older in 2020, making these diseases important targets for prevention and treatment. Undercorrected refractive error remains the largest contributor to global moderate and severe vision impairment (MSVI) in adults aged 50 years and older, with over 86 million individuals, approximately 42% of the 206 million cases of global MSVI. Cataract remained the largest contributor to global blindness in adults aged 50 years and older in 2020, with over 15 million individuals, approximately 45% of the 33♶ million cases of global blindness. We found that in adults aged 50 years and older there was no change in the crude prevalence of avoidable vision impairment between 20, and case numbers increased. Leading causes of MSVI were undercorrected refractive error (86♱ million cases ) and cataract (78♸ million cases ). The leading global causes of blindness in those aged 50 years and older in 2020 were cataract (15♲ million cases ), followed by glaucoma (3♶ million cases ), undercorrected refractive error (2♳ million cases ), age-related macular degeneration (1♸ million cases ), and diabetic retinopathy (0♸6 million cases ). However, the number of cases increased for both avoidable blindness (10♸% ) and MSVI (31♵% ). Age-standardised prevalence of avoidable blindness decreased by −15♴%, while avoidable MSVI showed no change (0♵% ). Global crude prevalence of avoidable vision impairment and blindness in adults aged 50 years and older did not change between 20 (percentage change −0♲% 2019 prevalence 9♵8 cases per 1000 people, 2010 prevalence 96♰ cases per 1000 people ). Advancing women in science, medicine and global health.The Lancet Regional Health – Western Pacific.The Lancet Gastroenterology & Hepatology.
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