JMIR Public Health and Surveillance · 5 authors, 1 centre
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This study analyzed global cataract burden from 1990 to 2019 using GBD data, finding that while age-standardized DALY rates decreased, total DALYs increased from 3.49 million to 6.68 million. Risk factors included age, female sex, air pollution, smoking, high fasting plasma glucose, and high BMI, with higher burden in low-SDI regions. Projections indicate continued rise in DALYs through 2034, emphasizing the need for targeted prevention and treatment policies.
**Background:** Cataracts are a leading cause of blindness globally, accounting for nearly half of blindness in low-income countries. Disability-adjusted life years (DALYs) reflect the disease burden, and understanding trends is crucial for prevention. This study aimed to assess global cataract burden from 1990 to 2019 using age-period-cohort modeling and predict trends to 2034.
**Methods:** Data were obtained from the Global Burden of Disease Study 2019, United Nations Development Programme, and WHO Global Health Observatory. DALY numbers and age-standardized DALY rates (ASDRs) were analyzed by region, age, sex, and socio-demographic index (SDI). Linear regression assessed associations between ASDR and SDI, human development index (HDI), PM2.5 concentration, and ambient ultraviolet radiation (UVR). The Nordpred age-period-cohort model predicted burden from 2020 to 2034, with sensitivity analysis using Bayesian age-period-cohort model.
**Key Results:** Globally, DALYs due to cataract increased from 3,492,604 (95% UI 2,481,846-4,719,629) in 1990 to 6,676,281 (95% UI 4,761,210-9,006,193) in 2019. ASDR decreased from 93.17 (95% UI 66.14-125.32) to 82.94 (95% UI 59.06-111.75) per 100,000, with an average annual percentage change (AAPC) of –0.37 (95% CI –0.44 to –0.3; P<.001). Females had higher DALY numbers and ASDR than males in both years. ASDR was highest in South Asia (198.39 in 2019) and lowest in high-income North America (17.43). ASDR was negatively correlated with SDI (R²=0.1939; P<.001) and HDI (R²=0.2828; P<.001), and positively correlated with PM2.5 (R²=0.1874; P<.001) and UVR (R²=0.2354; P<.001). Air pollution was the largest attributable risk factor in low-SDI regions. The prediction model indicated that DALY numbers will continue to rise globally through 2034, while ASDR will continue to decrease.
**Clinical Implications:** The increasing total DALYs despite declining rates highlight the growing burden due to population aging and growth. Targeted interventions should focus on older adults and females in low-income countries, addressing modifiable risk factors like air pollution, smoking, high fasting plasma glucose, and high BMI. Improving access to cataract surgery and preventive measures (e.g., UV protection, pollution control) is essential. The findings support resource allocation and health policy planning to manage the anticipated rise in cataract burden over the next 15 years.