# Female predominance and socio-demographic inequalities in global near vision loss burden: projected trends and disparities from 1990 to 2035

## TL;DR

Near vision loss is increasing globally, especially among women and in low-income regions, driven by population growth and healthcare disparities.

## Contribution

This study projects global near vision loss trends and highlights gender and socioeconomic disparities using comprehensive GBD data and advanced modeling.

## Key findings

- Global near vision loss cases increased from 428 million to 1.155 billion between 1990 and 2021.
- Females had a higher age-standardized prevalence of near vision loss compared to males in 2021.
- Socioeconomic inequities in near vision loss widened, with a significant DALY gap between high- and low-SDI regions.

## Abstract

Near vision loss (NVL), a hallmark of aging populations, imposes a growing global health burden, exacerbated by demographic shifts and socioeconomic disparities. Despite its profound impact on productivity and quality of life, comprehensive analyses that integrate aging, socioeconomic development, and sex-specific disparities remain limited.

Using the Global Burden of Disease (GBD) 2021 dataset spanning 204 countries and territories (1990–2021), we evaluated the NVL burden through prevalence, disability-adjusted life years (DALYs), and sociodemographic index (SDI). Advanced methodologies included decomposition analysis to disentangle demographic and epidemiological drivers, Bayesian age-period-cohort (BAPC) modeling for projections, and frontier analysis to quantify SDI-linked inequities. Gender-stratified and age-specific trends were analyzed using joinpoint regression analysis.

Global NVL prevalence surged from 428 million to 1.155 billion cases (1990–2021). Females exhibited a higher age-standardized prevalence (16,588 vs. 14,718 per 100,000 in 2021). South Asia had the highest burden (age-standardized DALYs: 208.0), whereas the Gulf Cooperation Council reported the lowest (93.8). Socioeconomic inequities widened: The DALY gap between high- and low-SDI regions expanded from 10.19 to 31.96. Population growth (65.3%) and epidemiological shifts (39.2%) drove DALY increases, offset marginally by aging (−4.4%).

NVL burden escalated disproportionately in low-SDI regions and among females, fueled by population growth and systemic healthcare gaps. Aging, while a minor contributor globally, critically affects the high-income Asia-Pacific region. Policymakers must prioritize sex-sensitive refractive care programs, expand optical subsidies in underserved areas, and address digital near-work hazards to mitigate the premature onset of NVL.