Poverty and eye health, including vision disability from vision impairment and blindness, are believed to be interrelated. The relationship between poverty and eye health can be interpreted as being two-fold, in the sense that poverty may be a cause of poor eye health and poor eye health may lead to or deepen poverty. Evidence shows that the burden of vision impairment is high in poor people and vision impairment and poverty are linked to each other. However the empirical evidence to answer the questions—Does poverty perpetuate poor eye health? How and why? Does poor eye health deepen poverty?—is sparse globally; especially from low and middle income countries (LMICs). This article therefore aims to examine published information and other secondary data sources that provide insight on the relationship between poverty and eye health, including eye disability caused from vision impairment and blindness. The article provides a conceptual understanding of poverty related attributes that contribute to eye disability from vision impairment and blindness, using evidence sourced from poverty and eye health research studies. The article interrogates general theories and beliefs that have been conceptualised in relation to the impact that the vicious cycle of poverty has on eye health and the contribution of poor eye health on an individual’s poverty status. The major outcomes of this article include: 1) identifying gaps in linking poverty and eye health, 2) establishing key issues that will assist in the development of a theoretical framework, and 3) preparing more appropriately for further investigation on the association between poverty and eye health.
Mitra, S., Posarac, A. and Vick, B. (2011) Disability and Poverty in Developing Countries: A Snapshot from the World Health Survey. World Bank Discussion Paper, No. 1109. http://wwwwds.worldbank.org
Santiaguel, M. The Role of Cooperatives in Global Poverty Reduction. http://www.cooperativeunionofcavite.com
International Fund for Agricultural Development (IFAD) (2011) Rural Poverty Report 2011: Overview. www.ifad.org/rpr2011
Grant, U. (2010) Spatial Inequality and Urban Poverty Traps. Overseas Development Institute Working Paper 326. http://www.odi.org.uk/sites/odi.org.uk/files/odi-assets/publications-opinion-files/5502.pdf
Naidoo, K. (2007) Poverty and Blindness in Africa. Clinical and Experimental Optometry, 90, 415-421. http://dx.doi.org/10.1111/j.1444-0938.2007.00197.x
Kuper, H., Polack, S., Eusebio, C., Mathenge, W., Wadud, Z. and Foster, A. (2008) A Case-Control Study to Assess the Relationship between Poverty and Visual Impairment from Cataract in Kenya, the Philippines and Bangladesh. Plos Medicine, 5, e244. http://dx.doi.org/10.1371/journal.pmed.0050244
UN-Habitat (2007) Urban Poverty and Slum Dwellers. http://www.unhabitat.org/
World Health Organisation (2011) Prevention of Blindness and Visual Impairment, Priority Eye Diseases. http://www.who.int/blindness/causes/priority/en/index2.html
Pascolini, D. and Mariotti, S.P. (2012) Global Estimates of Visual Impairment: 2010. British Journal of Ophthalmology, 96, 614-618. http://dx.doi.org/10.1136/bjophthalmol-2011-300539
Resnikoff, S., Pascolini, D., Mariotti, S.P. and Pokharel, G.P. (2008) Global Magnitude of Visual Impairment Caused by Uncorrected Refractive Errors in 2004. Bulletin of World Health Organization, 86, 63-70. http://dx.doi.org/10.2471/BLT.07.041210
World Health Organisation (2010) Causes of Blindness and Visual Impairment. Prevention of Blindness and Visual Impairment. http://www.who.int/blindness/causes/en/
Gooding, K. (2006) Poverty and Blindness: A Survey of the Literature. Sightsavers. International Programme Development Unit. http://www.sightsavers.org
Khanna, R., Raman, U. and Rao, G. (2007) Blindness and Poverty in India: The Way forward. Clinical and Experimental Optometry, 90, 406-414. http://dx.doi.org/10.1111/j.1444-0938.2007.00199.x
International Labour Office (2011) Equality at Work: The Continuing Challenge. Report of the Director-General under the Follow-Up to the ILO Declaration on Fundamental Principles and Rights at Work. International Labour Conference 100th Session Report I (B), Geneva.
Christian Blind Mission (2011) Cataract Report Shows Financial Gains for Under-Developed Countries. Media Release. http://www.cbmarchive.org
European Commission (2003) Guidance Note on Disability and Development for EU Delegations and Services. DG Development, Brussels.
Elwan, A. (1999) Poverty and Disability: A Survey of the Literature. Social Protection Unit, Human Development Network, World Bank, Social Protection Discussion Paper No. 9932. www.handicap-international.fr/bibliographie.../HandPovSurvey.pdf
Holden, B.A., Fricke, T.R. and Ho, S.M. (2008) Global Vision Impairment Due to Uncorrected Presbyopia. Archive of Ophthalmology, 126, 1731-1739. http://dx.doi.org/10.1001/archopht.126.12.1731
Javitt, J., Sommer, A. and Venkataswamy, G. (1983) The Economic and Social Impact of Restoring Sight. In: Henkind, P. Ed., ACTA: 24th International Congress of Ophthalmology, Philadelphia, 1308-1312.
Popivker, L., Wang, S.W. and Boerner, K. (2010) Eyes on the Prize: Life Goals in the Context of Visual Disability in Midlife. Clinical Rehabilitation, 24, 1127-1135. http://dx.doi.org/10.1177/0269215510371421
McCarty, C.A., Nanjan, M.B. and Taylor, H.R. (2001) Vision Impairment Predicts 5 Years Mortality. British Journal of Ophthalmology, 85, 322-326. http://dx.doi.org/10.1136/bjo.85.3.322
Polack, S., Kuper, H., Mathenge, W., Fletcher, A. and Foster, A. (2007) Cataract Visual Impairment and Quality of Life in a Kenyan Population. British Journal of Ophthalmology, 91, 927-932. http://dx.doi.org/10.1136/bjo.2006.110973
Polack, S., Kuper, H., Wadud, Z., Fletcher, A. and Foster, A. (2008) Quality of Life and Visual Impairment from Cataract in Satkhara District. Bangladesh. British Journal of Ophthalmology, 92, 1026-1030. http://dx.doi.org/10.1136/bjo.2007.134791
Vu, H.T., Keeffe, J.E., McCarty, C.A. and Taylor, H.R. (2005) Impact of Unilateral and Bilateral Vision Loss on Quality of Life. British Journal of Ophthalmology, 89, 360-363. http://dx.doi.org/10.1136/bjo.2004.047498
Rein, D.B., Zhang, P., Wirth, K.E., Lee, P.P., Hoerger, T.J., McCall, N., Klein, R., Tielsch, J.M., Vijan, S. and Saaddine, J. (2006) The Economic Burden of Major Adult Visual Disorders in the United States. Archive of Ophthalmology, 124, 1754-1760. http://dx.doi.org/10.1001/archopht.124.12.1754
Ho, V.H. and Schwab, I.R. (2001) Social Economic Development in the Prevention of Global Blindness. British Journal of Ophthalmology, 85, 653-657. http://dx.doi.org/10.1136/bjo.85.6.653
Frick, K.D. (2012) What the Comprehensive Economic of Blindness and Visual Impairment Can Help Us to Understand. Indian Journal of Ophthalmology, 60, 406-410. http://dx.doi.org/10.4103/0301-4738.100535
Vale, D. (2004) Unseen: Neglect, Isolation and Household Poverty amongst Older People with Sight Loss. Royal Institute of Blind, London. http://www.rnib.org.uk/livingwithsightloss/Documents/Unseen_Report_PDF.pdf
Gilbert, C.E., Shah, S.P., Jadoon, R.B., Dineen, B., Khan, A.M., Johnson, G.J. and Khan, M.D. (2008) Poverty and Blindness in Pakistan: Results from the Pakistan National Blindness and Visual Impairment Survey. British Medical Journal, 336, 29-32. http://dx.doi.org/10.1136/bmj.39395.500046.AE
Dandona, R. and Dandona, L. (2001) Review of Findings of the Andhra Pradesh Eye Disease Study: Policy Implications for Eye-Care Services. Current Ophthalmology, 49, 215-234.
Essue, B.M., Hackett, M.L., Mueller, A., Duc, N.T.H., Phuc, H.T. and Jan, S. (2011) Investigating the Psychological and Economic Impact of Cataract Surgery in Vietnam: The Visionary Observational Study Protocol. BMC Ophthalmology, 11, 25. http://dx.doi.org/10.1186/1471-2415-11-25
Lamoureux, E., Fenwick, E., Moore, K., Klaic, M., Borschmann, K. and Hill, K. (2009) Impact of the Severity of Distance and Near-Vision Impairment on Depression and Vision-Specific Quality of Life in Older People Living in Residential Care. Investigative Ophthalmology and Visual Science, 50, 4103-4109. http://dx.doi.org/10.1167/iovs.08-3294
Payot, A. and Barrington, K.J. (2011) The Quality of Life of Young Children and Infants with Chronic Medical Problems: Review of the Literature. Current Problems in Pediatric and Adolescent Health Care, 41, 91-101. http://dx.doi.org/10.1016/j.cppeds.2010.10.008
Kuper, H., Polack, S., Mathenge, W., Eusebio, C., Wadud, Z., Rashid, M. and Foster, A. (2010) Does Cataract Surgery Alleviate Poverty? Evidence from a Multi-Centre Intervention Study Conducted in Kenya, the Philippines and Bangladesh. PLoS ONE, 5, Article ID: e15431. http://dx.doi.org/10.1371/journal.pone.0015431
Du Toit, R., Palagyi, A., Ramke, J., Brian, G. and Lamoureux, E.L. (2010) The Impact of Reduced Distance and Near Vision on the Quality of Life of Adults in Timor-Leste. Ophthalmology, 117, 2308-2314. http://dx.doi.org/10.1016/j.ophtha.2010.03.041
Frick, K.D. and Foster, A. (2003) The Magnitude and Cost of Global Blindness: An Increasing Problem that Can Be Alleviated. American Journal of Ophthalmology, 135, 471-476. http://dx.doi.org/10.1016/S0002-9394(02)02110-4
Bekibele, C. and Gureje, O. (2008) Impact of Self-Reported Visual Impairment on Quality of Life in the Ibadan Study of Aging. British Journal of Ophthalmology, 92, 612-615. http://dx.doi.org/10.1136/bjo.2007.124859
Richman, J., Lorenzana, L.L., Lankaranian, D., Dugar, J., Mayer, J., Wizov, S. and Spaeth, G. (2010) Relationships in Glaucoma Patients between Standard Vision Tests, Quality of Life and Ability to Perform Daily Activities. Ophthalmic Epidemiology, 17, 144-151. http://dx.doi.org/10.3109/09286581003734878
Lee, P.P., Smith, J.P. and Kington, R. (1999) The Association between Self-Rated Vision and Hearing and Functional Status in Middle Age. Ophthalmology, 106, 401-405. http://dx.doi.org/10.1016/S0161-6420(99)90082-9
Lee, P.P., Smith, J.P. and Kington, R. (1999) The Relationship of Self-Rated Vision and Hearing to Functional Status and Well-Being among Seniors 70 Years and Older. American Journal of Ophthalmology, 127, 447-452. http://dx.doi.org/10.1016/S0002-9394(98)00418-8
Keeffe, J.E., Chou, S.L. and Lamoureux, E.L. (2009) The Cost of Care for People with Impaired Vision in Australia. JAMA Ophthalmology, 127, 1377-1381. http://dx.doi.org/10.1001/archophthalmol.2009.242
Majeed, M., Williams, C., Northstone, K. and Ben-Shlomo, Y. (2008) Are There Inequities in the Utilisation of Childhood Eye-Care Services in Relation to Socio-Economic Status? Evidence from the ALSPAC Cohort. British Journal of Ophthalmology, 92, 965-969. http://dx.doi.org/10.1136/bjo.2007.134841
Nirmalan, P.K., Padvathi, A. and Thulsiraj, R.D. (2003) Sex Inequalities in Cataract Blindness, Burden and Surgical Services in South India. British Journal of Ophthalmology, 87, 847-849. http://dx.doi.org/10.1136/bjo.87.7.847
Sommer, A. (2012) Under-Utilization of Eye Services. American Journal of Preventive Medicine, 43, 119-120. http://dx.doi.org/10.1016/j.amepre.2012.03.010
Baker, R.S., Bazargan, M., Bazargan-Hejazi, S. and Calderón, J.L. (2005) Access to Vision Care in an Urban Low-Income Multi-Ethnic Population. Ophthalmic Epidemiology, 12, 1-12. http://dx.doi.org/10.1080/09286580590921330
Tielsch, J.M., Sommer, A., Katz, J., Quigley, H. and Ezrine, S. (1991) Socio-Economic Status and Visual Impairment among Urban Americans. JAMA Ophthalmology, 109, 637-641. http://dx.doi.org/10.1001/archopht.1991.01080050051027
Bourne, R.R., Dineen, B.P., Huq, D.M., Ali, S.M. and Johnson, G.J. (2004) Correction of Refractive Error in the Adult Population of Bangladesh: Meeting the Unmet Need. Investigative Ophthalmology and Visual Science, 45, 410-417. http://dx.doi.org/10.1167/iovs.03-0129
Mathenge, W., Kuper, H., Polack, S., Onyango, O., Nyaga, G. and Foster, A. (2007) Rapid Assessment of Avoidable Blindness in Nakuru District, Kenya. Ophthalmology, 114, 599-605. http://dx.doi.org/10.1016/j.ophtha.2006.06.057
He, M., Chan, V., Baruwa, E., Gilbert, D., Frick, K.D. and Congdon, N. (2007) Willingness to Pay for Cataract Surgery in Rural Southern China. Ophthalmology, 114, 411-416. http://dx.doi.org/10.1016/j.ophtha.2006.09.012
Kessy, J.P. and Lewallen, S. (2007) Poverty as a Barrier to Accessing Cataract Surgery: A Study from Tanzania. British Journal of Ophthalmology, 91, 1114-1116. http://dx.doi.org/10.1136/bjo.2006.112474
Ashaye, A., Ajuwon, A.J. and Adeoti, C. (2006) Perception of Blindness and Blinding Eye Conditions in Rural Communities. Journal of the National Medical Association, 98, 887-893.
Maher, P. (1999) A Review of “Traditional” Aboriginal Health Beliefs. Australian Journal of Rural Health, 7, 229-236. http://dx.doi.org/10.1046/j.1440-1584.1999.00264.x
Holden, B.A. (2007) Blindness and Poverty: A Tragic Combination. Clinical and Experimental Optometry, 90, 401-403. http://dx.doi.org/10.1111/j.1444-0938.2007.00217.x
Kasi, P.M., Gilani, A.I., Ahmad, K. and Janjua, N.Z. (2004) Blinding Trachoma: A Disease of Poverty. PLoS Medicine, 1, Article ID: e44. http://dx.doi.org/10.1371/journal.pmed.0010044
Hoechsmann, A., Metcalfe, N., Kanjaloti, S., Godia, H., Mtambo, O., Chipeta, T., Barrows, J., Witte, C. and Courtright, P. (2001) Reduction of Trachoma in the Absence of Antibiotic Treatment: Evidence from a Population-Based Survey in Malawi. Ophthalmic Epidemiology, 8, 145-153. http://dx.doi.org/10.1076/opep.8.2.145.4169
Frazier, M. and Kleinstein, R.N. (2009) Access and Barriers to Vision, Eye, and Health Care. Optometric Care within the Public Health Community. Old Post Publishing, Cadyville, New York.
Brien Holden Vision Institute Foundation (International Centre for Eyecare Education) (2006) Situational Analysis on Refractive Error and Low Vision Services in East, Central and Southern Africa.
Hou, F. and Chen, J. (2003) Neighbourhood Low Income, Income Inequality and Health in Toronto. Health Reports, 14, 21-34.
Dienye, P.O., Brisibe, S.F. and Eke, R. (2011) Sources of Healthcare Financing among Surgical Patients in a Rural Niger Delta Practice in Nigeria. Rural and Remote Health, 11, 1577. http://www.rrh.org.au/publishedarticles/article_print_1577.pdf
World Hunger Education Service (2011) World Hunger and Poverty Facts and Statistics. www.worldhunger.org
Ryskulova, A., Turczyn, K., Makuc, D.M., Cotch, M.F., Klein, R.J. and Janiszewski, R. (2008) Self-Reported Age-Related Eye Diseases and Visual Impairment in the United States: Results of the 2002 National Health Interview Survey. American Journal of Public Health, 98, 454-461. http://dx.doi.org/10.2105/AJPH.2006.098202
Lewallen, S. (2008) Poverty and Cataract—A Deeper Look at a Complex Issue. PLoS Medicine, 5, Article ID: e245. http://dx.doi.org/10.1371/journal.pmed.0050245
Baker, W. (2002) Rural Fuel Poverty Defining a Research Agenda. A Report to Eagle Charitable Trust, Centre for Sustanable Development. http://hdl.handle.net/10068/529067
Melese, M., Alemayehu, W., Friedlander, E. and Courtright, P. (2004) Indirect Costs Associated with Accessing Eye Care Services as a Barrier to Service Use in Ethiopia. Tropical Medicine and International Health, 9, 426-431. http://dx.doi.org/10.1111/j.1365-3156.2004.01205.x
Faal, H. and Gilbert, C. (2007) Convincing Governments to Act: Vision 2020 and the Millennium Development Goals. Community Eye Health Journal, 20, 62-64.
Gersbeck, J. (2010) Eye Health and the MDGs: Progress in Asia and the Pacific.
Palmer, M. (2011) Disability and Poverty: A Conceptual Review. Journal of Disability Policy Studies, 21, 210-218. http://dx.doi.org/10.1177/1044207310389333
Sen, A. (1997) From Income Inequality to Economic Inequality. Southern Economic Journal, 64, 383-401. http://dx.doi.org/10.2307/1060857
(2009) The War on Poverty Campaign Report. Presentation to the Portfolio Committee on Social Development. http://www.pmg.org.za/docs/2009/091013waronpoverty-edit.pdf