An analysis of the global, regional, and national burden of blindness and vision loss between 1990 and 2021: the findings of the Global Burden of Disease Study 2021.

OBJECTIVES

To evaluate the global burden of blindness and vision loss (BVL) from 1990 to 2021 using a retrospective analysis of epidemiological data from Global Burden of Disease (GBD) study 2021 and to project trends over the next 15 years.

METHODS

This retrospective study analyzed data on years lived with disability (YLDs) and prevalence across 204 countries and territories. Trends over time were assessed using estimated annual percentage change (EAPC) of the age-standardized rates (ASR), while decomposition analysis quantified the contributions of population aging, growth, and epidemiological shifts. Socioeconomic disparities were evaluated using the Slope Index of Inequality and the Concentration Index. Future trends in age-standardized prevalence rates (ASPR) and age-standardized YLDs rates (ASYR) were projected using Bayesian age-period-cohort modeling.

RESULTS

Between 1990 and 2021, global YLDs due to BVL more than doubled, increasing from 14.31 to 29.16 million. The prevalence of BVL surged by 246.8%, with a disproportionately higher burden observed among females. Regions with low to middle Socio-Demographic Index (SDI) scores exhibited the highest ASPR and ASYR. Population growth and aging were the primary drivers of the increasing burden, while epidemiological trends had mixed effects. Significant socioeconomic disparities persist, with a higher concentration of BVL burden in economically disadvantaged regions. Projections indicate a continued increase in BVL burden through 2036, particularly among women and older populations.

CONCLUSION

Despite advancements in healthcare, the global burden of BVL has substantially increased over the past 32 years, driven by demographic and socioeconomic factors. Persistent disparities highlight the urgent need for targeted public health interventions, equitable resource allocation, and policy initiatives to address the growing impact of BVL worldwide.