Abstract
OBJECTIVES: Eye injury poses a significant challenge to the global burden of blindness. Using the Global Burden of Disease (GBD) database, this study aims to comprehensively assess the latest global burden of eye injury and examine its relationship with the Socio-Demographic Index (SDI). DESIGN: Observational study. PARTICIPANTS: Population-based data on eye injury from the GBD 2021 database, covering the period 1990-2021. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes included incidence, prevalence and years lived with disability (YLDs) due to eye injury. Secondary outcomes included temporal trends analysed using joinpoint regression, age-period-cohort effects, health inequality indices (Slope Index of Inequality (SII) and Concentration Index) and decomposition analysis of contributing factors. RESULTS: From 1990 to 2021, global eye injury incidence (in thousands) increased from 33 702.80 (95% uncertainty interval (UI): 27 271.41 to 44 086.12) to 39 996.91 cases (95% UI: 32 341.74 to 52 215.74), while age-standardised incidence rates (ASIR) declined from 622.73 to 503.26 per 100 000 population (average annual percent change (AAPC): -0.63, 95% confidence interval (CI) -0.81 to -0.46, p<0.001). High SDI regions showed the highest ASIR (775.56 per 100 000) compared with low SDI regions (368.26 per 100 000) in 2021. Males bore a greater burden, particularly in high-middle SDI regions (ASIR: 989.98 vs 317.09 per 100 000 for females). Age-period-cohort analysis revealed young adults (20-24 years) had the highest risk across all regions, while high SDI regions uniquely showed accelerating rates among the elderly (>75 years). Health inequality between SDI regions narrowed (SII decreased from 3.10 to 2.21 per 100 000), with population growth contributing 207.93% to increased incidence. CONCLUSION: The burden of eye injury exhibits distinct patterns across development levels, requiring tailored interventions: occupational safety for young adults in developing regions and fall prevention for the elderly in developed areas. Prevention strategies should align with regional economic development stages, emphasising workplace safety in industrialising regions while maintaining robust healthcare accessibility.