Population Dynamic Projections of Near Vision Loss and Refractive Disorders in China and the G20 From 1990 to 2038

BACKGROUND Near vision loss (NVL) and refractive disorders (RD) are vision impairments that impact quality of life and economic factors globally. Public health planning requires understanding their burdens and predicting trends. MATERIAL AND METHODS Using Global Burden of Disease (GBD) 2021 data, we analyzed age-standardized prevalence rates (ASPR) and disability-adjusted life year rates (ASDR) for China and the G20 from 1990 to 2021. Trends were described using actual and estimated annual percentage changes. Bayesian age-period-cohort modeling predicted disease burden from 2022 to 2038. Decomposition analysis quantified contributions from population growth, aging, and epidemiological changes. RESULTS NVL ASPR in China was 40 341.49 per 100 000, higher than in the G20. RD ASPR in China was 3044.90 per 100 000, lower than in the G20. Both conditions were more prevalent among women. NVL burden was highest in the 55 to 64 age group; RD burden peaked in the 80 to 84 age group. Overall, NVL showed an increasing trend (China: +1.95%; G20: +1.92%); RD showed a decreasing trend (China: -0.46%; G20: -0.36%). NVL burden is projected to continue rising, whereas RD burden will decline by 2038; both are mainly influenced by population growth. CONCLUSIONS We identified divergent trends for NVL and RD in China and the G20 among adults. NVL burden has increased since the mid-1990s and is projected to continue rising through 2038; RD rates have declined. Burdens remain higher in women, particularly in middle-aged (NVL) and older (RD) populations. These findings support sustained, demographically responsive eye health planning.