Objective  To understand the current disease burden of cataract in China in 2021, and predict the development trend of disease burden of cataract in China from 2022 to 2050.

Methods  The data of cataract disease burden in China and the world were obtained from the Global Burden of Disease Study 2021 (GBD 2021). The data included prevalence, disability-adjusted life year (DALY), and age-standardized rate. These indicators were used to describe the current situation of the disease burden of cataract in China and the world in 2021, and the estimated annual percentage change (EAPC) was used to analyze the change trend of the disease burden of cataract in China from 1990 to 2021. Furthermore, a Bayesian age-period-cohort model was constructed using R 4.2.3 software to predict the overall prevalence and DALY changes for cataract in China from 2022 to 2050.

Results  From 1990 to 2021, the number of individuals with cataract globally increased from 42.332[95% uncertain interval (UI): 37.403-47.527] million to 100.571 (95%UI: 88.772-114.033) million, while in China, the number increased from 5.684 (95%UI: 4.918-6.514) million to 19.785 (95%UI: 16.950-22.758) million, representing a 137.6% and 248.1% increase, respectively. The disease burden indicators for cataract were consistently higher in women than men during this period, and the disease burden increased with age. The peak burden for cataract in both global and Chinese populations was observed in the 70-75 age group. According to projections from a Bayesian age-period-cohort model, by 2050, the estimated number of men with cataract in China will be 31.733 million, and the number of women with cataract will be approximately 54.561 million. The predicted absolute number of DALY associated with cataract in men will be approximately 1.117 million per year, and the corresponding number for women will be approximately 2.428 million per year.

Conclusion  The disease burden of cataract in China has increased from 1990 to 2021, with a higher prevalence among women compared to men. Predictive models indicate that age-standardized prevalence rates will continue to rise over the next three decades, suggesting a persistent high burden of cataract in China. The escalating disease burden of cataract posed a significant challenge, necessitating concerted efforts from government, healthcare institutions, and society as a whole to implement effective measures to reduce cataract incidence and disability rates, ensuring the well-being of the population.

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