Burden of cataract in the Western Pacific Region from 1990 to 2023: an analysis based on the Global Burden of Disease study

This study provides a comprehensive assessment of the cataract burden in the Western Pacific Region (WPR) from 1990 to 2023, utilizing the latest estimates from the Global Burden of Disease (GBD). Despite a notable decline in age-standardized prevalence and disability-adjusted life year rates, the absolute burden has escalated dramatically. Our analysis reveals significant geographic heterogeneity, with the higher burdens concentrated in Southeast Asian and Pacific Island nations, contrasting sharply with the lower levels observed in high-income settings. Notably, the cataract burden exhibited a steep, non-linear increase after 50, with females consistently experiencing a higher disease burden across nearly all age strata. Decomposition analysis identified population growth as the largest estimated contributor of the increase in absolute burden, while the impact of demographic aging was particularly pronounced in super-aging societies like Japan and Korea. Furthermore, a critical shift in risk-factor attribution was observed: while traditional environmental risks declined, metabolic factors, including high body mass index and fasting plasma glucose, showed increasing contributions to cataract-related disability. These findings underscore the profound challenge posed by sensory aging, emphasizing older adults, particularly women, and the need for region-specific strategies integrating equitable surgical access and metabolic risk management to promote healthy aging across the WPR.