The Refractive Error and Vision Impairment Estimation With Spectacle data (REVIEWS) study

Abstract

AbstractObjectiveTo investigate whether spectacle lens sales data can be used to estimate the population distribution of refractive error amongst ametropes and hence estimate the current and future risk of vision impairment.DesignCross Sectional StudySubjectsA total 141,547,436 spectacle lens sales records from an international European lens manufacturer between the years 1998 and 2016.MethodsAnonymized patient spectacle lens sales data including refractive error information was provided by a major European spectacle lens manufacturer. Data from the Gutenberg Health Survey was digitized to allow comparison of a representative, population-based sample to the spectacle lens sales data. A bootstrap analysis was completed to assess the comparability of both datasets. The expected level of vision impairment due to myopia at age 75 was calculated for both datasets using a previously published risk estimation equation combined with a saturation function.Main Outcome MeasuresComparability of spectacle lens sales data on refractive error to typical population surveys of refractive error and its potential utility to predict vision impairment due to refractive error.ResultsEquivalent estimates of the population distribution of spherical equivalent refraction can be provided from spectacle lens data within limits. For myopia, the population distribution was equivalent to the Gutenberg Health Survey (≤ 5% deviation) for levels ≤-2.0 dioptres, while for hyperopia the distribution was equivalent (≤ 5% deviation) for levels ≥ +3.0 diopters. The estimated rates of vision impairment due to myopia were not statistically significantly different (χ2 = 182, DoF = 169, p = 0.234) between the spectacle lens data and Gutenberg Health Survey data.ConclusionsThe distribution of refractive error and hence the risk of vision impairment due to refractive error within a population can be determined using spectacle lens sales data. Pooling this type of data from multiple industry sources could provide a cost effective, timely and globally representative mechanism for monitoring the evolving epidemiology of refractive error and associated vision impairment.