Prevalence, causes, and barriers of severe visual impairment and blindness in Arab countries: A systematic review and...

Visual impairment (VI), including severe visual impairment (SVI; visual acuity < 6/60 to ≥ 3/60) and blindness (VA < 3/60), is a critical public health issue in Arab countries, exacerbated by socioeconomic disparities and limited access to eye care services.

This systematic review and meta-analysis estimates the prevalence of SVI and blindness in Arab countries using WHO ICD-11 definitions, identifies primary causes, and examines barriers to equitable eye health.

English- and Arabic-language studies were searched across multiple databases. The quality of the included studies was assessed using the JBI appraisal tool. Pooled prevalence estimates were calculated using a random-effects model in Jamovi.

Twenty-eight studies met the inclusion criteria. The pooled prevalence of SVI was 4.0 % (95 % CI: 2.49-5.51 %) and blindness was 4.65 % (95 % CI: 3.26-6.04 %), both exceeding global averages (3.78 % and 0.55 %, respectively). Primary causes included cataracts (29-66.2 %), diabetic retinopathy (32.9 %), glaucoma (24-55.7 %), and uncorrected refractive errors (48.6 %). Reported barriers to eye care access included financial constraints, geographic inaccessibility, a shortage of trained personnel, social stigma, and educational exclusion, disproportionately affecting women, rural communities, and marginalized groups. The causes of VI varied by age group: congenital anomalies and retinopathy of prematurity (ROP) were more prevalent among infants and children, while cataracts and glaucoma were predominant in older adults.

The high prevalence of severe VI and blindness in Arab countries reflects underlying systemic challenges. Policies should prioritize mobile eye clinics, neonatal screening (e.g., for ROP), specialist workforce training, subsidized surgeries, and early habilitation to improve developmental outcomes and quality of life for children. Culturally sensitive awareness campaigns, assistive technologies, and regional collaboration are essential to promote equitable eye care.