Purpose  This paper presents estimates of the prevalence of blindness and low vision among older adults over 50 years of age in mainland China.

Methods  All primary reports of population-based studies that reported prevalence or incidence of visual impairment among older populations in mainland China were identified. Twenty-four population-based studies were included in this systematic review. Blindness is defined as visual acuity of less than 3/60, or a corresponding visual field loss to less than 10 degrees in the better eye with best possible correction; low vision is defined as visual acuity of less than 6/18, but equal to or better than 3/60 in the better eye with best possible correction. The pooled prevalence estimates of blindness and low vision were calculated assuming a random effects model. Relative odds with 95% confidence intervals (CIs) were calculated stratified by methodological and socioeconomic variables.

Results  The overall pooled prevalence of blindness was 1.7% (95%CI=1.4-2.1). The results of the meta-regression showed the significance of a predictor variable: geographic region. Blindness rates per 100 older adults in various regions were 1.4 (0.9-2.0) in East China, and 1.4 (1.0-2.0) in Central China, 2.5 (1.9-3.2) in Western China. The overall pooled prevalence of low vision was 4.1% (3.4-5.1), and the independent pooled prevalence rates stratified by geographic region were 3.6 (2.6-5.1) in East China, and 3.6 (2.4-5.2) in Central China, 5.2 (3.6-7.4) in Western China

Conclusions  Blindness or low vision affects approximately 5.8% Chinese adults older than 50 years. The prevalence of visual impairment, and especially blindness, vary greatly by the development status of geographic region.