# Global burden and cross-country inequalities of age-related eye diseases from 1990 to 2021: a comprehensive analysis of temporal trends and socioeconomic disparities

## TL;DR

This study examines global trends in age-related eye diseases from 1990 to 2021, highlighting persistent inequalities and the need for targeted public health strategies.

## Contribution

The study provides a comprehensive analysis of socioeconomic disparities in age-related eye diseases using global data and advanced statistical methods.

## Key findings

- Global YLDs for age-related eye diseases increased from 78.503 to 100.006 between 1990 and 2021.
- Inequalities in age-related macular degeneration and cataracts decreased in low-SDI countries.
- Regional disparities persist, with low-SDI regions showing the most significant need for intervention.

## Abstract

Age-related eye diseases (AREDs) are leading causes of visual impairment worldwide. With global population aging, understanding their epidemiological trends and socioeconomic disparities is crucial for public health planning and equitable resource allocation.

We conducted a secondary epidemiological analysis of AREDs using data from the Global Burden of Disease (GBD) Study 2021. We evaluated years lived with disability (YLDs) and age-standardized YLD rates (ASYR) and conducted trend analysis using Joinpoint regression. Cross-country inequalities were assessed using the slope index of inequality (SII) and concentration index, with correlation and regression analyses examining associations with the socio-demographic index (SDI).

Global YLDs for AREDs increased from 78.503 to 100.006, while ASYR decreased from 112.815 to 92.803 per 100,000 populations between 1990 and 2021. Despite a global increase in the relative burden of glaucoma, both absolute and relative inequalities for age-related macular degeneration (AMD) and cataracts decreased. Low-SDI countries showed slight improvements in reducing these inequalities. The SII for AREDs improved in lower-SDI countries between 1990 and 2021, with reductions in AMD (from − 9.250 to − 6.033), cataract (from − 258.131 to − 173.762), and glaucoma (from − 21.090 to − 20.064). The concentration index for AMD and cataract decreased from − 0.167 and − 0.335 in 1990 to − 0.129 and − 0.272 in 2021, respectively, while the concentration index for glaucoma increased from − 0.208 to − 0.263, Regional disparities in the AREDs burden were evident, with most regions showing improved inequality in lower-SDI countries as reflected in both the SII and concentration index.

Despite global improvements in the relative burden of AREDs, significant socioeconomic and geographical inequalities persist, particularly in low-SDI regions. Targeted public health strategies and strengthened eye care systems are urgently needed to address these disparities and achieve equitable eye health outcomes worldwide.

The online version contains supplementary material available at 10.1186/s40662-026-00473-5.