First, the good news. A new paper in this month’s Lancet has suggested that the prevalence in blindness and visual impairment (VI) worldwide is reducing.

The paper by a team of authors, led by Professor Rupert Bourne from Anglia Ruskin University and funded by the Brien Holden Institute, has analysed the data first collated back in 2015 and compared it with similar data from 1990. In 2015, there were 36 million blind, 217 million with severe or moderate distance visual impairment and 1.1 billion near-vision impaired. This represents a reduction in VI prevalence from 4.58% in 1990 to 3.38% in 2015. The vast majority of VI people (89%) live in low and middle income countries, and 55% are women.

Now, the bad news. The growth and ageing of the global population is influencing the numbers affected, and this is clearly reflected in the impact of uncorrected presbyopia. Indeed, it has been estimated that about 80% of the world’s visually impaired people have treatable eye diseases, according to the World Health Organisation.

In this issue we highlight developments in two countries aimed at addressing the problem. One paper shows how overseas intervention can make an immediate if limited impact. The other shows how infrastructure investment and training makes a longer standing impact, but requires time, money and political will.

The International Agency for the Prevention of Blindness (IAPB) is involved in the Vision 2020 project and has produced (and is updating, in the light of the new data) an IAPB Vision Atlas. The Atlas will explain causes in different locations, offer country-level progress indicators, and publish commentary from experts on a variety of eye health issues. By bringing all this information together, the Vision Atlas becomes a powerful tool for advocacy, planning and fund-raising. This co-ordinated and targeted approach has got to be the way to alleviate this, in theory, perfectly avoidable human tragedy.