Global, regional, national differences and gender disparity in the burden of cataract: current trends and future...

This research investigates cataract incidence patterns in individuals aged 60 and older, projects future trends, and offers insights to inform targeted preventive actions.

Data on cataract incidence were sourced from the 2021 Global Burden of Disease dataset. The study assessed links with the Socio-Demographic Index (SDI), examined disparities, and employed frontier and decomposition analyses to uncover mechanisms of burden evolution. Trends across age groups, time periods, and birth cohorts were explored using an Age-Period-Cohort (APC) framework, while the Bayesian Age-Period-Cohort (BAPC) model enabled future burden projections.

From 1990 to 2021, cataract cases surged globally, rising from 32.8 million to over 82 million. Despite this, the age-adjusted rate declined overall, except in low- and middle-SDI settings, where increases persisted. Disparities remain pronounced in less-developed regions, though the absolute inequality gap has lessened. Population expansion emerged as the primary contributor to incidence growth. Projections suggest low-income regions will bear a disproportionate burden, while high-SDI areas benefit from early screening and improved care. By 2030, cataract cases may reach 111 million, with stable age-standardised rates.

The global cataract burden is escalating, primarily driven by demographic shifts. Resource-limited countries, particularly China and India, will confront rising challenges. Region-specific strategies, especially enhancing access to eye care and surgery in underserved areas, are essential to curbing the future impact.