Global Ophthalmology Research Output Relative to Disease Burden and National Income, 2011–2021

Purpose: To characterize ophthalmology research output relative to disease burden and national economic capacity after accounting for population size. Methods: We analyzed Scopus publications, Global Burden of Disease disability-adjusted life years (DALYs), and World Bank economic and population data from 2011 to 2021. Negative binomial and Gamma models evaluated publication volume and positive citation-weighted impact, adjusting for DALYs, gross domestic product (GDP) per capita, population, disease category, and publication year. Results: Refractive disorders accounted for 45.4% of DALYs and 23.2% of publication volume; cataract, 44.7% and 29.8%; glaucoma, 5.2% and 30.6%; and age-related macular degeneration, 3.8% and 15.2%. High-income countries accounted for 11.8% of burden, 67.2% of publication volume, and 74.2% of citation-weighted impact; lower-middle-income countries accounted for 49.1%, 7.9%, and 6.8%, respectively. DALYs were not independently associated with publication volume (adjusted count ratio [aCR], 0.99; 95% confidence interval [CI], 0.98–1.01; p = 0.278), whereas GDP per capita (aCR, 4.47) and population (aCR, 13.99) were strongly associated (both p < 0.001). For positive citation-weighted impact, DALYs had a small association (adjusted ratio of means [aRM], 1.05), whereas GDP per capita (aRM, 2.86) and population (aRM, 4.96) were strongly associated (all p < 0.001). Conclusions: After accounting for population size, absolute disease burden was not independently associated with publication volume, whereas national economic capacity remained strongly associated with both outcomes. These patterns should inform research and service-delivery priorities.