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From the mid-20th century onwards ( figure 1), there have been major technological advances in microsurgical techniques for cataract and other conditions, and equipment for diagnosis and treatment of major non-communicable eye diseases, resulting in more effective interventions. Lastly, we address the question of how health systems can practically advance towards delivering high quality integrated people-centred eye care within universal health coverage.Įye health started with an understanding of the anatomy, physiology, diseases of the eye, and the development of clinical ophthalmology, the medical and surgical discipline for diagnosis and treatment of eye diseases. In section 5, we outline a bibliometric analysis of eye health research since 2000, and report a global Grand Challenges project, highlighting crucial issues for concerted research and action. We present a new estimate of global lost productivity associated with vision impairment for 2020, and an analysis of the cost-effectiveness ratios for cataract surgery and refractive error services. In section 4, we summarise findings from a systematic review of eye health economics, identifying important areas for future work. We propose a more standardised approach to reporting population-based eye health surveys and examine the disability weights applied to vision impairment. We explore service needs of people with non-vision impairing eye conditions. In section 3, we describe the magnitude and causes of vision impairment in 2020 and projected global and regional trends. In section 2, we synthesise several reviews done by the Commission on the relevance of eye health to the Sustainable Development Goals (SDGs), as well as its impact on quality of life, general health, and mortality. In section 1 we summarise the visual system, vision impairment, and common conditions. Second, looking beyond 2020, we examine approaches to enable delivery of eye health services within universal health coverage. First, we present evidence for the importance of eye health, supporting the case for urgent action. This report broadly divides into two halves. Vision impairment reduces mobility, affects mental wellbeing, exacerbates risk of dementia, increases likelihood of falls and road traffic crashes, increases the need for social care, and ultimately leads to higher mortality rates. Although high-quality data for global economic estimates are scarce, particularly for LMICs, conservative assessments based on the latest prevalence figures for 2020 suggest that annual global productivity loss from vision impairment is approximately US$410♷ billion purchasing power parity. Vision loss has substantial financial implications for affected individuals, families, and communities. Poor eye health and impaired vision have a negative effect on quality of life and restrict equitable access to and achievement in education and the workplace. Eye health is essential to achieve many of the Sustainable Development Goals (SDGs). This Commission defines eye health as maximised vision, ocular health, and functional ability, thereby contributing to overall health and wellbeing, social inclusion, and quality of life. Advancing women in science, medicine and global health.The Lancet Regional Health – Western Pacific.The Lancet Gastroenterology & Hepatology.