Global burden for blindness and vision loss among women of childbearing age and perimenopause: age-period-cohort analysis 2021

Why this matters for everyday life

Seeing clearly is essential for working, caring for family, and staying independent. This study shows that hundreds of millions of women in their prime adult years are already living with serious sight problems—and that the numbers are rising fast. Understanding who is most affected, where they live, and why their risk is increasing can help societies act now to protect women’s vision, mental health, and ability to participate fully in community life.

Who is at risk and how big the problem is

The researchers focused on women between the ages of 20 and 55—those in childbearing years and the transition to menopause. Using data from the Global Burden of Disease 2021 project, which compiles health information from 204 countries and territories, they counted cases of blindness and vision loss caused by common eye problems such as uncorrected focus errors, cataracts, glaucoma, and age-related damage to the light-sensing layer at the back of the eye. In 2021, about 333 million women in this age range were living with moderate to complete vision loss, and 40 countries each had more than one million affected women. India, China, Brazil, and Indonesia alone each had over ten million women with serious sight problems.

Unequal impact across the world

To understand how development level relates to eye health, the authors grouped countries by a combined measure that reflects income, education, and birth rates. They found that women in poorer regions carried the heaviest burden of vision loss, even though all regions saw increases over the last three decades. Countries with lower development scores often lack enough eye doctors, screening programs, and affordable treatments like simple glasses or cataract surgery. Cultural and economic barriers can also keep women from seeking timely care. Yet some better-off regions showed the fastest growth in rates over time, suggesting that changing lifestyles and aging populations are adding to the problem even where services are stronger.

How age, time, and generation shape women’s vision

The team used an approach called age–period–cohort analysis to tease apart three influences: how risk changes as women grow older, how it changes over calendar time, and how it differs between generations born in different years. Across all world regions, the chance of vision loss rose sharply with age, especially after about 40. More than half of all affected women were between 40 and 54, the years surrounding menopause. Over the period from 1992 to 2021, the overall risk of vision loss in this age group climbed steadily in most regions, especially in low and middle development settings. Women born after the late 1960s generally faced higher risk than those born earlier, pointing to lasting generational effects such as changing health conditions, longer life spans, or exposure to new risk factors.

Why midlife women are especially vulnerable

The study highlights several reasons why vision problems cluster in women approaching menopause. Many eye conditions, including cataracts and glaucoma, become more common with age. On top of this, hormone shifts around menopause may worsen damage to the lens and the nerve cells that carry visual signals to the brain. Lower estrogen levels are linked in other research to higher eye pressure, more clouding of the lens, and greater vulnerability of the retina, while metabolic problems such as diabetes and abnormal blood fats also grow more frequent in midlife. Together, these changes help explain why women in their forties and early fifties now account for a growing share of global vision loss.

What the future may look like

Using statistical models that extend current trends into the future, the authors project that the number of women aged 20 to 55 living with blindness or serious vision loss could rise from 333 million in 2021 to about 400 million by 2035 and nearly 800 million by 2050, with the steepest increases expected among women aged 45 to 54. Because these projections assume no major breakthroughs in prevention or care, they serve as a warning rather than a fixed fate. The study concludes that protecting the sight of women in their working and caregiving years will require stronger eye-care systems, earlier screening, and targeted support for low- and middle-income countries. In simple terms, acting now to safeguard women’s vision could prevent immense personal hardship and economic loss in the decades ahead.

Citation: Liu, Y., Zeng, Y., Rong, R. et al. Global burden for blindness and vision loss among women of childbearing age and perimenopause: age-period-cohort analysis 2021. Sci Rep 16, 11101 (2026). https://doi.org/10.1038/s41598-026-41588-y

Keywords: women’s eye health, vision loss, perimenopause, global health, blindness burden