Table 2.
Eye health and Sustainable Development Goals
| Number and type of study | Summary of study findings | |
|---|---|---|
| Poverty-related (SDGs 1, 2, 8) | ||
| Relative productivity in the workplace | One (randomised controlled trial) | Provision of free spectacles to tea workers with presbyopia in India improved workplace relative productivity by 22% (p<0·0001)29 |
| Household per-capita expenditure | Two (prospective cohort studies) | Increase in household per-capita expenditure in people with vision impairment who underwent cataract surgery—eg, in the Philippines, increase by 88% over 1 year (p<0·001)30, 31 |
| Household income | Four (prospective cohort studies and one retrospective cohort study) | Household income increased after cataract surgery—eg, 1 year after provision of surgery for marginalised communities in rural India,32, 33, 34 the proportion of households with a monthly income (<1000 Rupees) decreased from 51% to 21% (p=0·05); in the USA,35 children who became blind by age of 6 years and attended vision impairment schools had a lower salary than those who attended public schools (possibly confounded by other determinants) |
| Employment rates | One (retrospective cohort study) | Vocational rehabilitation services for vision impairment in the USA were positively associated with paid employment—eg, training and support services increased odds of obtaining paid employment (odds ratio 1·10, p=0·001)36 |
| Economic productivity | Four (cost-effectiveness and evaluation studies) | Benefits to economic productivity from cataract surgery37, 38 and trichiasis surgery39, 40—eg, there was a net 13-year US$123·4-billion return on investment from a 1-year cohort after cataract surgery, including an increase in US national productivity of US$25·4 billion37 |
| Quality education (SDG 4) | ||
| Academic test scores | Seven (randomised controlled trials and prospective cohort studies) | Providing children with spectacles improved academic test scores41, 42, 43, 44, 45, 46, 47—eg, in China, vision correction reduced the odds of failing a class by 44% (p<0·01)43 |
| Reading or word identification | Two (cohort studies) | Improved reading and word identification with spectacle wear and attendance at specialised schools35, 48 |
| Inequalities (SDGs 5, 10) | ||
| Gender inequality | Three (systematic review with meta-analysis, and pair of cross-sectional surveys) | Reduced gender inequality in all-cause blindness, clinic attendance, cataract surgery coverage, and trachoma treatment coverage following interventions to promote eye services by trained rural community volunteers in low-income and middle-income countries;49 free cataract screening and low-cost quality cataract surgery in China reduced gender disparity in willingness to pay at 5-year follow-up (88% men, 91% women) compared with baseline (67% men, 50% women)50 |
| Equity (per-capita expenditure) | One (cohort study) | People who had cataract surgery in Kenya, the Philippines, and Bangladesh were poorer than non-visually impaired people before surgery (p≤0·02), but after surgery, there was no difference in household per-capita expenditure between the groups (p≥0·2), showing equity improvement33 |
| Inequalities in use of eye care services | One (series of repeat cross-sectional studies) | Free eye examinations in Scotland increased use of eye care services at the aggregate level but widened inequalities by income (p<0·001) and education (p<0·001) |
| Sustainable cities and communities (SDG 11) | ||
| Driving-related difficulties | One (meta-analysis) | Reduced driving-related difficulties after cataract surgery (pooled odds ratio 0·12, 95% CI 0·10–0·16)51 |
| Motor vehicle crashes | Five (observational studies) | Cataract surgery reduced motor vehicle crashes (all studies statistically significant)52, 53, 54, 55, 56 |
Changes in eye health following an intervention are directly linked to one or more Sustainable Development Goals.