title: Global Patterns in Health Burden of Uncorrected Refractive Error.
abstract: To evaluate the global patterns in health burden of uncorrected refractive error (URE) by year, age and sex, region, and socioeconomic status, using disability-adjusted life years (DALYs).
  
  
  
  Global, regional, or national DALY numbers, crude DALY rates, and age-standardized DALY rates caused by URE, by year, or age and sex, were obtained from the Global Burden of Disease Study 2013. Human development index (HDI) in 2013 as a national socioeconomic indicator was obtained from the Human Development Report. Kruskal-Wallis test and linear regression were performed to explore the association between age-standardized DALY rates and HDI.
  
  
  
  From 1990 to 2013, global DALY numbers caused by URE rose by 43.8%, crude rates remained relatively constant, and age-standardized rates fell by 8.8%. Global DALY rates increased with age, and older females had higher DALY numbers and rates than males of the same age. Age-standardized DALY rates in Eastern Mediterranean, South-East Asia, and Africa were higher than that at a global level. Multiple comparisons indicated higher age-standardized DALY rates in lower HDI countries. Age-standardized DALY rates were inversely related to HDI (standardized β = -0.616, P < 0.001).
  
  
  
  The global health of URE is improving but crude DALY rates are keeping constant, implying that health progress does not mean fewer demands of refractive services. Worldwide, older age, female sex, and lower socioeconomic status are associated with higher URE burden. The findings of this study may raise public awareness of the global URE burden and are important for health policy making.
authors.affiliation: Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Lixia
authors.initials: L
authors.lastname: Lou
authors.affiliation: Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Chunlei
authors.initials: C
authors.lastname: Yao
authors.affiliation: Department of Ophthalmology, Dongyang People's Hospital, Dongyang, Zhejiang, China.
authors.forename: Yanhua
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States.
authors.forename: Victor
authors.initials: V
authors.lastname: Perez
authors.affiliation: Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Ye
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D014943:Global Health; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D019057:Quality-Adjusted Life Years; D012029:Refraction, Ocular; D012030:Refractive Errors / Q000191:economics / Q000453:epidemiology* / Q000534:rehabilitation; D012189:Retrospective Studies; D055815:Young Adult