The Right to Women's Sight: Global, Regional, and National Burden of Blindness and Vision Loss in Women, 1990 to 2021.

Abstract

To quantify global, regional, and national burdens of blindness and vision loss among females from 1990 to 2021 and to assess age patterns, trends, causes, and risk factors contributing to sex disparities. Retrospective cohort analysis using publicly available, deidentified data from the Global Burden of Disease (GBD) 2021 study. Females across 204 countries and territories included in GBD 2021. Sex-specific estimates were analyzed; no identifiable human subjects were involved. Deidentified GBD 2021 data were analyzed using R (4.3.2) and Joinpoint regression. Prevalence and Years Lived with Disability (YLDs = prevalence × disability weight) were estimated globally and stratified by age, geography, and Sociodemographic Index. Descriptive analyses assessed trends from 1990 to 2021. Mapping illustrated regional distribution and estimated annual percentage change. Cause- and risk-factor analyses followed standardized GBD methods. Age-standardized and age-specific prevalence and YLD rates; leading causes; risk-factor-attributable YLDs; and temporal patterns by estimated annual percentage change. In 2021, females had a 27.1% higher prevalence of blindness and vision loss and a 17.2% higher YLD rate than males. Age-standardized prevalence and YLDs were 14,510.97 and 17,010.96 per 100,000. Burdens were highest in low- and middle-Sociodemographic Index regions. Near vision loss, cataract, and refractive disorders were leading causes; major contributors included air pollution, high BMI, and household air pollution. Women ≥70 years bore the highest disability burden. Joinpoint analysis showed a persistent increase in female YLDs without a clear COVID-19-related inflection. Limitations include modeled estimates and regional data heterogeneity. Females worldwide continue to experience a disproportionate burden of blindness and vision loss, especially in lower-resource settings and older age groups. Gender-responsive strategies and expanded access to eye care are urgently needed.