Persistent socioeconomic disparities and delayed onset in blindness due to neonatal disorders: global burden and future projections

Objective Blindness, a significant complication of neonatal disorders (ND) and their four subtypes, profoundly impacts individuals’ quality of life. This study assesses the global burden of blindness caused by ND to inform health policy development. Methods Data were obtained from the Global Burden of Disease Study 2021 (GBD 2021). Age-standardised prevalence and years lived with disability (YLDs) were analysed using estimated annual percentage changes (EAPCs) and joinpoint model. Health disparities were evaluated through Sociodemographic Index (SDI) via the Slope Index of Inequality (SII) and Concentration Index (CI). Decomposition analysis identified burden changes, and Bayesian age-period-cohort (BAPC) models projected trends through 2040. Results In 2021, global ND-related blindness cases exceeded 4.26 million, reflecting a 60.92% increase in prevalence and 61.33% rise in YLDs since 1990. Age-standardised prevalence rates (ASPR) and YLDs rates (ASYR) increased, with the EAPCs of 0.29 (95% CI 0.26 to 0.32) and 0.31 (95% CI 0.28 to 0.34), respectively, primarily driven by population growth and epidemiological change. Socioeconomic disparities persisted, with higher burdens in lower SDI regions. From 2005 to 2021, prevalence peaked in the 45–54 age group. Projections to 2040 indicated contrasting trends: a decline in prevalence based on 1990–2021 trends, but a slight increase based on 1990–2019 trends, prior to the COVID-19 pandemic. Conclusions The burden of ND-related blindness remains substantial. The heavier burden in low SDI regions and the delayed onset of blindness due to the cumulative effects of ND may be underestimated. Urgent improvements in medical resource allocation and long-term eye health follow-up for ND survivors are needed.