Journal Mobile Options
Table of Contents
Vol. 47, No. 4, 2012
Issue release date: April 2012
Section title: Review
Free Access
Ophthalmic Res 2012;47:171–188

Epidemiology of Major Eye Diseases Leading to Blindness in Europe: A Literature Review

Prokofyeva E. · Zrenner E.
Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
email Corresponding Author

Dr. med. Elena Prokofyeva, MD, MPH, PhD

Institute for Ophthalmic Research

Centre for Ophthalmology, University of Tübingen

Frondsberstrasse 23, DE–72076 Tübingen (Germany)



  1. West S, Sommer A: Prevention of blindness and priorities for the future. Bull World Health Organ 2001;79:244–248.
  2. Kocur I, Resnikoff S: Visual impairment and blindness in Europe and their prevention. Br J Ophthalmol 2002;86:716–722.
  3. Coleman HR, Chan CC, Ferris FL 3rd, Chew EY: Age-related macular degeneration. Lancet 2008;372:1835–1845.
  4. Klein R, Klein BE, Cruickshanks KJ: The prevalence of age-related maculopathy by geographic region and ethnicity. Prog Retin Eye Res 1999;18:371–389.
  5. Klein R, Klein BE, Linton KL: Prevalence of age-related maculopathy. The beaver dam eye study. Ophthalmology 1992;99:933–943.
  6. Varma R, Fraser-Bell S, Tan S, Klein R, Azen SP: Prevalence of age-related macular degeneration in Latinos: The Los Angeles Latino Eye Study. Ophthalmology 2004;111:1288–1297.
  7. Varma R, Torres M: Prevalence of lens opacities in Latinos: The Los Angeles Latino Eye Study. Ophthalmology 2004;111:1449–1456.
  8. Varma R, Torres M, Pena F, Klein R, Azen SP: Prevalence of diabetic retinopathy in adult Latinos: The Los Angeles Latino Eye Study. Ophthalmology 2004;111:1298–1306.
  9. Varma R, Ying-Lai M, Francis BA, Nguyen BB, Deneen J, Wilson MR, Azen SP: Prevalence of open-angle glaucoma and ocular hypertension in Latinos: The Los Angeles Latino Eye Study. Ophthalmology 2004;111:1439–1448.
  10. Friedman DS, Jampel HD, Munoz B, West SK: The prevalence of open-angle glaucoma among Blacks and Whites 73 years and older: The Salisbury Eye Evaluation Glaucoma Study. Arch Ophthalmol 2006;124:1625–1630.
  11. Munoz B, West SK, Rubin GS, Schein OD, Quigley HA, Bressler SB, Bandeen-Roche K: Causes of blindness and visual impairment in a population of older Americans: The Salisbury Eye Evaluation Study. Arch Ophthalmol 2000;118:819–825.
  12. Smith W, Assink J, Klein R, Mitchell P, Klaver CC, Klein BE, Hofman A, Jensen S, Wang JJ, de Jong PT: Risk factors for age-related macular degeneration: pooled findings from three continents. Ophthalmology 2001;108:697–704.
  13. Augood CA, Vingerling JR, de Jong PT, Chakravarthy U, Seland J, Soubrane G, Tomazzoli L, Topouzis F, Bentham G, Rahu M, Vioque J, Young IS, Fletcher AE: Prevalence of age-related maculopathy in older Europeans: The European Eye Study (Eureye). Arch Ophthalmol 2006;124:529–535.
  14. Astachov US, Lisochkin AB, Shadriev FE: Age-related macular degeneration; in Moshetova LK, Nesterov AP, Ugorov EA (eds): Clinical Ophthalmology Guidelines (in Russian). Moscow, GEOTAR-Media, 2008, pp 164–189.
  15. Lee ET, Lu M, Bennett PH, Keen H: Vascular disease in younger-onset diabetes: comparison of European, Asian And American Indian cohorts of the WHO Multinational Study of Vascular Disease In Diabetes. Diabetologia 2001;44(suppl 2):S78–S81.
  16. Miki E, Lu M, Lee ET, Keen H, Bennett PH, Russell D: The incidence of visual impairment and its determinants in the WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia 2001;44(suppl 2):S31–S36.
  17. Horle S, Gruner F, Kroll P: Epidemiology of diabetes-induced blindness – a review (in German). Klin Monbl Augenheilkd 2002;219:777–784.
  18. Topouzis F, Wilson MR, Harris A, Anastasopoulos E, Yu F, Mavroudis L, Pappas T, Koskosas A, Coleman AL: Prevalence of open-angle glaucoma in Greece: The Thessaloniki Eye Study. Am J Ophthalmol 2007;144:511–519.
  19. Tuck MW, Crick RP: The age distribution of primary open angle glaucoma. Ophthalmic Epidemiol 1998;5:173–183.
  20. Taylor HR: Epidemiology of age-related cataract. Eye (Lond) 1999;13:445–448.
  21. Navarro Esteban JJ, Gutierrez Leiva JA, Valero Caracena N, Buendia Bermejo J, Calle Puron ME, Martinez Vizcaino VJ: Prevalence and risk factors of lens opacities in the elderly in Cuenca, Spain. Eur J Ophthalmol 2007;17:29–37.
  22. van Leeuwen R, Klaver CC, Vingerling JR, Hofman A, de Jong PT: The risk and natural course of age-related maculopathy: Follow-up at 61/2 years in the Rotterdam study. Arch Ophthalmol 2003;121:519–526.
  23. Muchamedova AS, Aznabaev RA, Bikbov MM: Ethiopathogenesis of age-related macular degeneration (in Russian). Vestn Oftalmol 2007;123:43–45.
  24. Vorobieva MV, Polunin GS, Eliseeva EG: Recent aspects of pathogenesis of age-related macular dystrophy (in Russian). Vestn Oftalmol 2006;122:50–52.

    External Resources

  25. Despriet DD, Klaver CC, Witteman JC, Bergen AA, Kardys I, de Maat MP, Boekhoorn SS, Vingerling JR, Hofman A, Oostra BA, Uitterlinden AG, Stijnen T, van Duijn CM, de Jong PT: Complement factor H polymorphism, complement activators, and risk of age-related macular degeneration. JAMA 2006;296:301–309.
  26. Gruener F: Prävalenz, Inzidenz und Ursache von Blindheit und wesentlicher Sehbehinderung in Hessen, Marburg; Diss, Marburg, 2001.
  27. Cohen D, Sartral M, Nounou P, Hamar M, Drouard ME, El Alamy A, Bendeddouche K: Evaluation of moderate and severe visual impairments in patients attending an ophthalmology clinic. A prospective study of 1,172 patients (in French). J Fr Ophtalmol 2000;23:437–443.
  28. Owen CG, Fletcher AE, Donoghue M, Rudnicka AR: How big is the burden of visual loss caused by age related macular degeneration in the United Kingdom? Br J Ophthalmol 2003;87:312–317.
  29. Bannikova RV, Sannikov AL, Konovalov AV: Characteristics of ophthalmic pathology under the conditions of the European North of Russia (in Russian). Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2002:35–36.

    External Resources

  30. Klaver CC, Assink JJ, van Leeuwen R, Wolfs RC, Vingerling JR, Stijnen T, Hofman A, de Jong PT: Incidence and progression rates of age-related maculopathy: the Rotterdam study. Invest Ophthalmol Vis Sci 2001;42:2237–2241.
  31. Krumpaszky HG, Ludtke R, Mickler A, Klauss V, Selbmann HK: Blindness incidence in Germany. A population-based study from Württemberg-Hohenzollern. Ophthalmologica 1999;213:176–182.
  32. Resnikoff S, Pascolini D, Etya’ale D, Kocur I, Pararajasegaram R, Pokharel GP, Mariotti SP: Global data on visual impairment in the year 2002. Bull World Health Organ 2004;82:844–851.
  33. Simmons D, Clover G, Hope C: Ethnic differences in diabetic retinopathy. Diabet Med 2007;24:1093–1098.
  34. Keen H, Lee ET, Russell D, Miki E, Bennett PH, Lu M: The appearance of retinopathy and progression to proliferative retinopathy: the WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia 2001;44(suppl 2):S22–S30.
  35. Shurshukov YY, Konovalov IM, Savelieva ES, Konovalova AV: Investigation of distribution of eye diseases and supplementary apparatus basing on the monitoring data (in Russian). Zdravoochrananie Rossiiskoi Federatii 2007:53–54.
  36. Alabyeva GU, Nesterov AP: Glaucoma; in Moshetova LK, Nesterov AP, Ugorov EA (eds): Clinical Ophthalmology Guidelines (in Russian). Moscow, GEOTAR-Media, 2008, pp 97–124.
  37. Moshetova LK, Nesterov AP, Ugorov EA: Diabetic Retinopathy; in Moshetova LK, Nesterov AP, Ugorov EA (eds): Clinical Ophthalmology Guidelines (in Russian). Moscow, GEOTAR-Media, 2008, pp 139–140.
  38. Fernandez-Vigo J, Sanchez Macho J, Diaz Rey A, Barros J, Tome M, Bueno J: The prevalence of diabetic retinopathy in Northwest Spain. An epidemiological study of diabetic retinopathy in Galicia. I. Acta Ophthalmol (Copenh) 1993;71:22–26.
  39. Blum M, Kloos C, Muller N, Mandecka A, Berner R, Bertram B, Muller UA: Prevalence of diabetic retinopathy. Check-up program of a public health insurance company in Germany 2002—2004 (in German). Ophthalmologe 2007;104:499–500, 502–494.
  40. Hesse L, Grusser M, Hoffstadt K, Jorgens V, Hartmann P, Kroll P: Population-based study of diabetic retinopathy in Wolfsburg (in German). Ophthalmologe 2001;98:1065–1068.
  41. Giuffre G, Lodato G, Dardanoni G: Prevalence and risk factors of diabetic retinopathy in adult and elderly subjects: The Casteldaccia Eye Study. Graefes Arch Clin Exp Ophthalmol 2004;242:535–540.
  42. Sparrow JM, McLeod BK, Smith TD, Birch MK, Rosenthal AR: The prevalence of diabetic retinopathy and maculopathy and their risk factors in the non-insulin-treated diabetic patients of an English town. Eye (Lond) 1993;7:158–163.
  43. Teruel Maicas C, Fernandez-Real JM, Ricart W, Valent Ferrer R, Valles Prats M: Prevalence of diabetic retinopathy in the region of Girona. Study of related factors (in Spanish). Arch Soc Esp Oftalmol 2005;80:85–91.
  44. Lopez IM, Diez A, Velilla S, Rueda A, Alvarez A, Pastor CJ: Prevalence of diabetic retinopathy and eye care in a rural area of Spain. Ophthalmic Epidemiol 2002;9:205–214.
  45. Skenduli-Bala E, de Voogd S, Wolfs RC, van Leeuwen R, Ikram MK, Jonas JB, Bakker D, Hofman A, de Jong PT: Causes of incident visual field loss in a general elderly population: The Rotterdam study. Arch Ophthalmol 2005;123:233–238.
  46. Waked N, Saad A, Mehanna C, Sleilaty G, Kortbaoui R: Prevalence, causes, and risk factors for blindness and visual impairment among nursing home residents in Lebanon (in French). J Fr Ophtalmol 2007;30:497–502.
  47. Santos Bueso E, Fernandez-Vigo J, Fernandez Perez C, Macarro Merino A, Fernandez Perianes J: Prevalence of diabetic retinopathy in the regional community of Extremadura. 1997–2001 (Extremadura Project to Prevent Blindness) (in Spanish). Arch Soc Esp Oftalmol 2005;80:187–194.
  48. Anton A, Andrada MT, Mujica V, Calle MA, Portela J, Mayo A: Prevalence of primary open-angle glaucoma in a spanish population: The Segovia study. J Glaucoma 2004;13:371–376.
  49. Villain M, Nordmann JP, Renard JP, Bron A, Delcourt C, Pinchinat S, Solesse de Gendre A, Pelen F: The French glaucoma and ocular hypertension 1-day study (in French). J Fr Ophtalmol 2006;29:520–525.
  50. Weinreb RN, Khaw PT: Primary open-angle glaucoma. Lancet 2004;363:1711–1720.
  51. Cedrone C, Culasso F, Cesareo M, Zapelloni A, Cedrone P, Cerulli L: Prevalence of glaucoma in Ponza, italy: a comparison with other studies. Ophthalmic Epidemiol 1997;4:59–72.
  52. Hitzl W, Ortner C, Hornykewycz K, Grabner G, Reitsamer HA: Resource use and costs for a glaucoma screening program in Austria: an 8-year review: a cost-consequence analysis based on the Salzburg-Moorfields Collaborative Glaucoma Study. Eur J Ophthalmol 2006;16:92–99.
  53. Tuck MW, Crick RP: The projected increase in glaucoma due to an ageing population. Ophthalmic Physiol Opt 2003;23:175–179.
  54. Kroese M, Burton H, Vardy S, Rimmer T, McCarter D: Prevalence of primary open angle glaucoma in general ophthalmic practice in the United Kingdom. Br J Ophthalmol 2002;86:978–980.
  55. Nesterov AP: Glaucoma, ocular hypertension; in Kopaeva VG (ed): Eye Diseases (in Russian). Moscow, Medicine, 2002, pp 353–385.
  56. Morbidity of the population of Arkhangelsk Oblast in 2006: Statistical Data, Arkhangelsk Oblast Administration, Department of Public Health, Medical Information Center. 2007, pp 19–140.
  57. Krumpaszky HG, Klauss V: Epidemiology of blindness and eye disease. Ophthalmologica 1996;210:1–84.
  58. Gohdes DM, Balamurugan A, Larsen BA, Maylahn C: Age-related eye diseases: an emerging challenge for public health professionals. Prev Chronic Dis 2005;2:A17.

    External Resources

  59. Verma L, Das T, Binder S, Heriot WJ, Kirchhof B, Venkatesh P, Krebs I, Stolba U, Jahn C, Feichtinger H, Kellner L, Krugluger H, Pawelka I, Frohner U, Kruger A, Li W, Tewari HK: New approaches in the management of choroidal neovascular membrane in age-related macular degeneration. Indian J Ophthalmol 2000;48:263–278.
  60. Laser photocoagulation for juxtafoveal choroidal neovascularization. Five-year results from randomized clinical trials. Macular photocoagulation study group. Arch Ophthalmol 1994;112:500–509.
  61. Rubin GS, Bressler NM: Effects of verteporfin therapy on contrast on sensitivity: results from the treatment of age-related macular degeneration with photodynamic therapy (TAP) investigation – TAP report No 4. Retina 2002;22:536–544.
  62. Oliver-Fernandez A, Bakal J, Segal S, Shah GK, Dugar A, Sharma S: Progression of visual loss and time between initial assessment and treatment of wet age-related macular degeneration. Can J Ophthalmol 2005;40:313–319.
  63. Klein ML, Ferris FL, 3rd, Armstrong J, Hwang TS, Chew EY, Bressler SB, Chandra SR: Retinal precursors and the development of geographic atrophy in age-related macular degeneration. Ophthalmology 2008;115:1026–1031.
  64. Cruess AF, Zlateva G, Xu X, Soubrane G, Pauleikhoff D, Lotery A, Mones J, Buggage R, Schaefer C, Knight T, Goss TF: Economic burden of bilateral neovascular age-related macular degeneration: Multi-country observational study. Pharmacoeconomics 2008;26:57–73.
  65. Coleman AL, Yu F: Eye-related medicare costs for patients with age-related macular degeneration from 1995 to 1999. Ophthalmology 2008;115:18–25.
  66. Brown MM, Brown GC, Brown HC, Peet J: A value-based medicine analysis of ranibizumab for the treatment of subfoveal neovascular macular degeneration. Ophthalmology 2008;115:1039–1045.
  67. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, β-carotene, and zinc for age-related macular degeneration and vision loss: AREDS report No 8. Arch Ophthalmol 2001;119:1417–1436.
  68. Javitt JC, Zlateva GP, Earnshaw SR, Pleil AM, Graham CN, Brogan AJ, Shah SN, Adamis AP: Cost-effectiveness model for neovascular age-related macular degeneration: comparing early and late treatment with pegaptanib sodium based on visual acuity. Value Health 2008;11:563–574.
  69. Hopley C, Salkeld G, Mitchell P: Cost utility of photodynamic therapy for predominantly classic neovascular age related macular degeneration. Br J Ophthalmol 2004;88:982–987.
  70. Brown GC, Brown MM, Sharma S, Brown H, Tasman W: Incremental cost effectiveness of laser photocoagulation for subfoveal choroidal neovascularization. Ophthalmology 2000;107:1374–1380.
  71. Brown GC, Brown MM, Brown HC, Kindermann S, Sharma S: A value-based medicine comparison of interventions for subfoveal neovascular macular degeneration. Ophthalmology 2007;114:1170–1178.
  72. Busbee BG, Brown MM, Brown GC, Sharma S: CME review: a cost-utility analysis of laser photocoagulation for extrafoveal choroidal neovascularization. Retina 2003;23:279–287; quiz 443–444.
  73. Mitchell P, Annemans L, White R, Gallagher M, Thomas S: Cost effectiveness of treatments for wet age-related macular degeneration. Pharmacoeconomics 2011;29:107–131.
  74. Harvey PT: Common eye diseases of elderly people: identifying and treating causes of vision loss. Gerontology 2003;49:1–11.
  75. Kristinsson JK: Diabetic retinopathy. Screening and prevention of blindness; thesis. Acta Ophthalmol Scand Suppl 1997:1–76.

    External Resources

  76. Infeld DA, O’Shea JG: Diabetic retinopathy. Postgrad Med J 1998;74:129–133.
  77. Idil A, Caliskan D, Ocaktan E: The prevalence of blindness and low vision in older onset diabetes mellitus and associated factors: a community-based study. Eur J Ophthalmol 2004;14:298–305.
  78. Davies R, Sullivan P, Canning C: Simulation of diabetic eye disease to compare screening policies. Br J Ophthalmol 1996;80:945–950.
  79. Hirskyj P: QALY: an ethical issue that dare not speak its name. Nurs Ethics 2007;14:72–82.
  80. Javitt JC, Aiello LP: Cost-effectiveness of detecting and treating diabetic retinopathy. Ann Intern Med 1996;124:164–169.
  81. Hamilton AMP, Ulbig MW, Polkinghorne P: Managment of diabetic retinopathy. London, BMJ Publishing Group, 1996.
  82. Michelson G, Groh MJ: Screening models for glaucoma. Curr Opin Ophthalmol 2001;12:105–111.
  83. Bourne RR: Worldwide glaucoma through the looking glass. Br J Ophthalmol 2006;90:253–254.
  84. Thylefors B, Negrel AD: The global impact of glaucoma. Bull World Health Organ 1994;72:323–326.
  85. Gray SF, Spry PG, Brookes ST, Peters TJ, Spencer IC, Baker IA, Sparrow JM, Easty DL: The Bristol Shared Care Glaucoma Study: outcome at follow-up at 2 years. Br J Ophthalmol 2000;84:456–463.
  86. Owen CG, Carey IM, De Wilde S, Whincup PH, Wormald R, Cook DG: The epidemiology of medical treatment for glaucoma and ocular hypertension in the United Kingdom: 1994 to 2003. Br J Ophthalmol 2006;90:861–868.
  87. Trautner C, Haastert B, Richter B, Berger M, Giani G: Incidence of blindness in Southern Germany due to glaucoma and degenerative conditions. Invest Ophthalmol Vis Sci 2003;44:1031–1034.
  88. Quigley HA, Broman AT: The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 2006;90:262–267.
  89. Gupta N, Weinreb RN: New definitions of glaucoma. Curr Opin Ophthalmol 1997;8:38–41.
  90. Hitzl W, Hornykewycz K, Grabner G, Reitsamer HA: On the relationship between age and prevalence and/or incidence of primary open-angle glaucoma in the ‘Salzburg-Moorfields collaborative glaucoma study’ (in German). Klin Monbl Augenheilkd 2007;224:115–119.
  91. Tuulonen A, Airaksinen PJ, Erola E, Forsman E, Friberg K, Kaila M, Klemetti A, Makela M, Oskala P, Puska P, Suoranta L, Teir H, Uusitalo H, Vainio-Jylha E, Vuori ML: The Finnish evidence-based guideline for open-angle glaucoma. Acta Ophthalmol Scand 2003;81:3–18.
  92. Krieglstein GK: Blindness caused by glaucoma (in German). Ophthalmologe 1993;90:554–556.
  93. Saw SM, Gazzard G, Friedman D, Foster PJ, Devereux JG, Wong ML, Seah S: Awareness of glaucoma, and health beliefs of patients suffering primary acute angle closure. Br J Ophthalmol 2003;87:446–449.
  94. Lee BL, Wilson MR: Ocular Hypertension Treatment Study (OHTS) commentary. Curr Opin Ophthalmol 2003;14:74–77.
  95. Koleva D, Motterlini N, Schiavone M, Garattini L: Medical costs of glaucoma and ocular hypertension in Italian referral centres: a prospective study. Ophthalmologica 2007;221:340–347.
  96. Traverso CE, Walt JG, Kelly SP, Hommer AH, Bron AM, Denis P, Nordmann JP, Renard JP, Bayer A, Grehn F, Pfeiffer N, Cedrone C, Gandolfi S, Orzalesi N, Nucci C, Rossetti L, Azuara-Blanco A, Bagnis A, Hitchings R, Salmon JF, Bricola G, Buchholz PM, Kotak SV, Katz LM, Siegartel LR, Doyle JJ: Direct costs of glaucoma and severity of the disease: a multinational long-term study of resource utilisation in Europe. Br J Ophthalmol 2005;89:1245–1249.
  97. Huang TC, Lee DA: Punctal occlusion and topical medications for glaucoma. Am J Ophthalmol 1989;107:151–155.
  98. Ariturk N, Oge I, Erkan D, Sullu Y, Sahin M: The effects of nasolacrimal canal blockage on topical medications for glaucoma. Acta Ophthalmol Scand 1996;74:411–413.
  99. Drance SM, Nash PA: The dose response of human intraocular pressure to pilocarpine. Can J Ophthalmol 1971;6:9–13.
  100. European Glaucoma Society. Terminology and Guidelines for Glaucoma, ed 3. Savana, Dagma, 2008.
  101. Johnson LN: Glaucoma: our role in reducing the burden of blindness. J Natl Med Assoc 2002;94:908–911.
  102. Schmier JK, Halpern MT, Jones ML: The economic implications of glaucoma: a literature review. Pharmacoeconomics 2007;25:287–308.
  103. Orme M, Boler A: Prostaglandin analogues for the treatment of glaucoma and ocular hypertension: a systematic review of economic evidence. Pharmacoeconomics 2006;24:743–750.
  104. Brainerd EL: Life expectancy in Eastern Europe. Science 2000;290:52–53.
  105. Bird AC, Bressler NM, Bressler SB, Chisholm IH, Coscas G, Davis MD, de Jong PT, Klaver CC, Klein BE, Klein R, et al: An international classification and grading system for age-related maculopathy and age-related macular degeneration. The International Arm Epidemiological Study Group. Surv Ophthalmol 1995;39:367–374.
  106. Early treatment diabetic retinopathy study design and baseline patient characteristics. ETDRS report No 7. Ophthalmology 1991;98:741–756.
  107. Fukuda M: Classification and treatment of diabetic retinopathy. Diabetes Res Clin Pract 1994;24(suppl):S171–S176.
  108. Weih LM, Nanjan M, McCarty CA, Taylor HR: Prevalence and predictors of open-angle glaucoma: results from the visual impairment project. Ophthalmology 2001;108:1966–1972.
  109. Pascolini D, Mariotti SP, Pokharel GP, Pararajasegaram R, Etya’ale D, Negrel AD, Resnikoff S: 2002 global update of available data on visual impairment: a compilation of population-based prevalence studies. Ophthalmic Epidemiol 2004;11:67–115.
  110. Acosta R, Hoffmeister L, Roman R, Comas M, Castilla M, Castells X: Systematic review of population-based studies of the prevalence of cataracts (in Spanish). Arch Soc Esp Oftalmol 2006;81:509–516.
  111. Alabama, Cartographic Research Laboratory, University of Alabama: Alabama maps project, 2009.