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Time trends, associations and global burden of intraocular foreign bodies
  1. Guangming Jin1,
  2. Minjie Zou1,2,
  3. Yichi Zhang3,
  4. Aiming Chen4,
  5. Charlotte Aimee Young5,
  6. Yi Li6,
  7. Ling Jin1,
  8. Nathan Congdon1,7,
  9. Danying Zheng1
  1. 1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
  2. 2Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
  3. 3Department of Ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
  4. 4Department of Pharmacy, Fifth Affiliated Hospital of Sun Yat- sen University, Zhuhai, China
  5. 5Department of Ophthalmology, Third Affiliated Hospital, Nanchang University, Nanchang, China
  6. 6School Of Pharmacy And Food Science, Zhuhai College Jilin University, Zhuhai, Guangdong, China
  7. 7Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
  1. Correspondence to Dr Danying Zheng, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China; zhengdyy{at}; Dr Nathan Congdon, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China; Centre for Public Health, Royal Victoria Hospital, Queen’s University Belfast, Belfast, UK; ncongdon1{at}


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.

  • epidemiology
  • public health
  • trauma

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  • GJ, MZ and YZ are joint first authors.

  • Contributors Conception and design: DZ and NC; Analysis and interpretation: YZ, AC, CAY, YL and LJ; Writing of the article: GJ, MZ and YZ; Critical revision of the article: DZ and NC; Data collection: GJ, MZ and YZ; Administrative, technical or logistical support: DZ and NC.

  • Funding This work was supported by National Natural Science Foundation of China (81873673, 81900841) and the Fundamental Research Funds of the State Key Laboratory of Ophthalmology(30306020240020212). GJ receives support from the Young Teachers Training Program of Sun Yat-sen University(20ykpy143). NC is supported by the Ulverscroft Foundation (UK).

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  • Competing interests NC declares that he is Director of Research for Orbis International, a non-governmental organisation working in global eye health, including reducing the burden of ocular trauma.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Zhongshan Ophthalmic Center Institutional Review Board and the tenets of the Declaration of Helsinki were observed throughout.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as online supplemental information. Data could be obtained by contact the corresponding authors by email.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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