Global Trends and Projections for Avoidable Visual Impairment among Working-Age Individuals: A Population-Based Study

Area of Science:

• Public Health
• Ophthalmology
• Global Health Economics

Background:

• Visual impairment (VI) in working-age populations presents significant public health and economic challenges.
• Avoidable causes, specifically cataract and refractive errors, require focused investigation.
• Understanding global trends and disparities in avoidable VI is crucial for targeted interventions.

Purpose of the Study:

• To quantify global trends, inequalities, and future projections of avoidable VI in the working-age demographic.
• To analyze changes in avoidable VI prevalence from 1990 to 2021.
• To project the burden of avoidable VI by the year 2040.

Main Methods:

• Utilized data from the Global Burden of Disease (GBD) 2021 study for prevalence and population estimates.
• Employed joinpoint regression analysis to assess trends by age, sex, sociodemographic index (SDI), and region.
• Applied Bayesian age-period-cohort modeling for future burden projections and evaluated inequalities using established indices.

Main Results:

• Overall avoidable VI prevalence in the working-age population declined from 1990-2021, mainly due to reduced refractive errors (AAPC -0.15%).
• Significant reductions in severe vision loss and blindness were observed, while moderate vision loss remained stable.
• Females bore a greater burden with slower improvement; socioeconomic disparities persisted, with lower SDI regions disproportionately affected, and an increasing trend noted in high SDI regions. Projections indicate a 23.4% rise in cases by 2040.

Conclusions:

• Despite overall progress, significant opportunities for improvement and persistent disparities in avoidable VI exist.
• The projected increase in avoidable VI cases necessitates enhanced, integrated eye health strategies.
• Substantial investment in accessible and affordable eye care, alongside fair employment policies for those with VI, is critical.