Time trends, associations and global burden of intraocular foreign bodies

PURPOSE: To estimate the disease burden due to intraocular foreign bodies (IOFBs) and evaluate contributions of various risk factors to IOFB-associated disability-adjusted life-years (DALYs). METHODS: Global, regional and country-level number, rate and age-standardised rate of DALYs due to IOFBs were acquired from the Global Burden of Disease Study 2017 database. The Human Development Index (HDI) and other region and country-level data were obtained from open databases. Time trends for number, rate and age-standardised rate of DALYs due to IOFBs were calculated. Regression analysis was used to evaluate associations between age-standardised rate of DALYs and potential predictors. RESULTS: Global DALYs due to IOFBs rose by 43.7% between 1990 (139 (95% CI 70.8 to 233) thousand) and 2017 (202 (95% CI 105 to 335) thousand). The DALY rate remained stable while the age-standardised rate decreased during this period. Higher disease burden due to IOFBs was associated with higher glaucoma prevalence (β=0.006, 95% CI 0.003 to 0.09, p<0.001), lower refractive error prevalence (β=-0.0005, 95% CI -0.0007 to -0.0002, p<0.001), and lower income (β=-0.020, 95% CI -0.035 to -0.006, p=0.007). CONCLUSION: Predictors of a greater burden of IOFB disability generally point to lower socioeconomic level. The association with glaucoma may reflect a complication of IOFB, increasing risk of vision loss and disability.