Thirty-year changes in burden for refraction disorders in China, Japan, Korea and Singapore: a jointly prevention perspective analysis

Uncorrected refractive error is a primary cause of global vision impairment, creating substantial health and economic burdens. This study aimed to analyze historical trends in the burden of refractive disorders from 1990 to 2021 and to project future trends to 2050, focusing on global, socio-demographic, and key Asian regional levels. Data on the prevalence and YLDs of refractive disorders were obtained from the Global Burden of Disease Study 2021. We analyzed age-standardized rates (ASR) globally, across five Socio-Demographic Index (SDI) quintiles, and for five Asian regions. Temporal trends were evaluated using Joinpoint regression to calculate the average annual percent change (AAPC). Future burden until 2050 was projected using a Bayesian Age-Period-Cohort (BAPC) model. From 1990 to 2021, the global age-standardized prevalence rate (ASPR) of refractive disorders decreased by 6.5%. The most significant declines occurred in low-SDI (11.8%) and low-middle-SDI (20.0%) regions. Among the selected Asian regions, Taiwan (10.1%) and China (6.4%) demonstrated the largest reductions. The burden was disproportionately high in older populations, with prevalence peaking in the 80–84 age group. Projections indicate a future shift in disease burden, with the ASPR in Japan and Taiwan forecasted to surpass that of China within the next decade. While significant progress has been made in reducing the burden of refractive disorders, particularly in lower-SDI regions, the burden is increasingly concentrating in the aging populations of higher-SDI countries. These findings underscore the urgent need for targeted public health strategies and enhanced eye care services to address the challenges posed by these demographic shifts.