Global, Regional, and National Burden of Blindness and Vision Loss in Individuals Aged 0 to 24 Years, 1990 to 2021: Divergent Trends, Inequalities and Projections Based on Global Burden of Disease 2021.

Abstract

To assess the global burden of blindness and vision loss (BVL) in individuals aged 0 to 24 years from 1990 to 2021, project trends, and analyze inequalities. Systematic epidemiological analysis of the Global Burden of Disease 2021 database. Data from 204 countries and territories, stratified by age, sex, and Socio-Demographic Index (SDI). Age-standardized prevalence rates (ASPR) and disability-adjusted life years (DALYs) were extracted from Global Burden of Disease 2021. Estimated annual percentage changes (EAPC) quantified trends. Analyses included decomposition, age-period-cohort modeling, frontier analysis, and inequality assessment via the Slope Index of Inequality and Concentration Index. ASPR and DALYs for BVL. From 1990 to 2021, the global age-standardized DALY rate decreased (EAPC: -0.20; 95% CI: -0.36 to -0.03), while ASPR slightly increased (EAPC: 0.02; 95% CI: -0.20 to 0.24). Absolute case numbers rose due to population growth. Females and older adolescents (15-24 years) bore a disproportionately higher burden. Low and middle SDI regions exhibited rising ASPR, while high SDI regions showed declines. Projections suggest rising total cases by 2030, with modest declines in ASPR and DALY rates. Frontier analysis indicated substantial improvement potential in several countries. Despite a global decrease in the health loss from BVL, the absolute number of affected young individuals is rising. The burden remains unequally distributed, with relative inequalities increasing over time. Targeted public health policies focusing on prevention, early intervention, and equitable resource allocation-especially in low SDI regions and among older adolescents-are urgently required.