Low-income Countries Face Highest Cataract Burden

Cataracts are the leading cause of blindness and significant visual impairment globally, especially among older adults, contributing to 51% of all blindness cases according to the World Health Organization. While cataract surgery is cost-effective, accessibility remains limited, particularly in low- and middle-income countries—an issue that will only intensify with an aging population. A new study found that cataract cases rose exponentially from 1990 to 2021, and projections indicate that the strain on healthcare systems will continue to rise until 2050. This burden will disproportionately impact women and individuals in areas with a low sociodemographic index, the report indicated. Total cataract cases rose substantially from 32.8 million in 1990 to 82.2 million in 2021. Age-specific trends revealed higher burdens among older populations, peaking in individuals aged 70 to 74, particularly among women. This chart from the study shows the global prevalence by age bracket and sex. Photo: Jiang X, et al. Br J Ophthalmol. August 18, 2025. Click image to enlarge. The researchers sourced data from the Global Burden of Disease 2021 database, which included information from 204 countries and territories, to analyze the global burden of cataracts from 1990 to 2021. Key indicators such as cataract prevalence, age-standardized prevalence rates, disability-adjusted life years (DALYs) and age-standardized DALY rates (ASDR) were assessed. Further analysis was conducted to discern long-term trends and predict future cataract burdens extending to 2050.The results were compelling: the total number of prevalent cataract cases surged from 32.8 million in 1990 to 82.2 million in 2021. Moreover, DALYs attributable to cataracts increased from 2.5 million to 5.2 million, highlighting a growing public health concern.The age-specific analysis indicated that age-standardized prevalence rates and ASDR peaked in the 70 to 74 age group before showing a decline in older age brackets. Disparities were especially pronounced across sociodemographic index quintiles, with higher burdens observed in regions such as South Asia and sub-Saharan Africa, largely attributable to limited surgical access and systemic healthcare deficiencies. Cataract burden in these countries was also influenced by modifiable risk factors such as air pollution and metabolic issues. Conversely, high-income countries experienced improvements in ASDR due to advancements in cataract surgery and diagnostic capabilities. The researchers commented on these findings in their paper for British Journal of Ophthalmology, noting that, “While cataract prevalence has continued to rise due to demographic changes, the ASDR has shown a declining trend, suggesting that advancements in medical interventions have effectively reduced the functional impairment associated with cataracts. However,” they continued, “significant heterogeneity exists in burdens across different regions, socioeconomic groups and demographic subpopulations, indicating that the complex interplay of biological, environmental and systemic factors shapes the epidemiological patterns of this disease.”These insights underscore the urgent need for targeted public health interventions and policy reforms aimed at improving surgical access and reducing disparities in cataract care, especially in lower-income countries, the researchers concluded. Click here for the journal source. Jiang X, Xu B, Zhai J, et al. Global trends in cataract burden: a 30-year epidemiological analysis and prediction of 2050 from the Global Burden of Disease 2021 study. Br J Ophthalmol. August 18, 2025. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.