Research Appraisalother

Global, regional, and national trends in blindness and vision loss, 1990-2021: a secondary ecological trend analysis based on modelled population estimates.

Journal of global healthWu, Shi-Nan, Jiang, Yuqi, Guan, Wenying et al.29 May 2026DOI

Clinical Snapshot

60CEBM
Evidence: Moderateother

PICO Framework

P — PopulationGlobal population across all age groups from 1990-2021, stratified by sociodemographic index (SDI) regions
I — InterventionNot applicable - observational trend analysis
C — ComparatorTemporal trends and regional/national comparisons across different SDI levels
O — OutcomesPrevalence and age-standardised prevalence rates of blindness and vision loss, disability-adjusted life years (DALYs), and average annual percent changes by cause, age, and region

Bottom Line

This comprehensive global analysis reveals a concerning 27% increase in age-standardised blindness and vision loss prevalence from 1990-2021, driven primarily by near vision loss and cataract. While disability-adjusted life years remained stable, suggesting improved management of severe cases, the rising prevalence indicates growing healthcare demands. The disproportionate burden in low-SDI regions highlights global health inequities. For Australian clinicians, these trends support continued investment in preventive eye care, particularly for aging populations and diabetes management. The stable DALY rates despite increasing prevalence suggest that current treatments are effective at preventing severe disability, reinforcing the value of early detection and intervention strategies already embedded in Australian clinical guidelines.

Evidence: Moderate

Key Findings

  • P Value: P < 0.001

  • Effect Size: AAPC of 0.85% annual increase in prevalence

  • Primary Outcome: Age-standardised prevalence rate of blindness and vision loss increased globally from 12,453.52 to 15,784.33 per 100,000 population

  • Nnt Or Sensitivity: Near vision loss showed highest increase with AAPC of 1.14% (95% CI: 0.94, 1.51)

  • Confidence Interval: 95% CI: 0.7, 1.11

Clinical Application

Data supports evidence-based resource allocation and screening program development Findings align with Australian Institute of Health and Welfare vision loss data. Relevant for PBS funding decisions for vision-related treatments and RACGP guidelines for diabetic eye screening and age-related eye disease prevention Relevant to Australian population as part of high-SDI region, particularly for planning ophthalmology services and public health interventions

Abstract

BACKGROUND: We aimed to provide global, regional, and national estimates of the burden of blindness and vision loss from 1990 to 2021, stratified by cause, age, and sociodemographic index (SDI). METHODS: This population-based study used data from the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD) study, covering 1990 to 2021. It evaluates the burden of blindness and vision loss based on prevalence, age-standardised prevalence rate (ASPR), disability-adjusted life years (DALYs), age-standardised DALY rate (ASR of DALY), and average annual percent changes (AAPCs). RESULTS: Globally, the ASPR of blindness and vision loss increased from 12 453.52 (95% uncertainty interval (UI) = 10 287.58, 15 226.09) in 1990 to 15 784.33 (95% UI = 12 761.44, 19 502.32) in 2021, with an AAPC of 0.85 (95% confidence interval (CI) = 0.7, 1.11, P < 0.001). In contrast, the ASR of DALYs remained stable, changing from 342.01 (95% UI = 237.87, 482.17) in 1990 to 342.78 (95% UI = 224.21, 503.61) in 2021, with an AAPC of 0.05 (95% CI = -0.04, 0.2, P = 0.298). Notably, near vision loss and cataract showed consistent increases, with AAPCs of 1.14 (95% CI = 0.94, 1.51, P < 0.001) and 0.25 (95% CI = 0.16, 0.33, P < 0.001), respectively. Blindness and vision loss prevalence was significantly higher in low and low-middle SDI regions compared to other SDI regions. CONCLUSIONS: Global blindness and vision loss increased from 1990 to 2021, while DALYs stayed stable. Prevention should be tailored by region, country, gender, cause, and age.

References

  1. 1.Wu, S.-N., Jiang, Y., Guan, W., Xu, C., Zeng, D.-X., Yan, B., Lv, J., Huang, C., Hu, J., Han, Y., & Liu, Z. (2026). Global, regional, and national trends in blindness and vision loss, 1990-2021: a secondary ecological trend analysis based on modelled population estimates. Journal of Global Health, 16, 04176. https://doi.org/10.7189/jogh.16.04176
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