Global, regional, and national prevalence of pterygium in 2023: a systematic review and modelling analysis.

Abstract

Pterygium contributes to otherwise avoidable vision loss and reduced quality of life worldwide. Despite its treatability and the availability of low-cost interventions, it is often overlooked in global health strategies. We aimed to estimate global, regional, and national pterygium prevalence and examine variations in prevalence by age and sex. We systematically searched PubMed, Embase, and MEDLINE for articles reporting on the prevalence of pterygium published from 1 January 1990 to 25 September 2024. For China-specific data, we supplemented this search with articles included in a prior systematic review and meta-analysis, and an updated search of four Chinese databases (CNKI, Wanfang, CBM, and VIP) from 1 January 2016 to 25 September 2024. We developed multilevel multivariable mixed-effects meta-regression models to estimate the global, regional, and national age- and sex-specific prevalences of pterygium in 2023, and an associated factor-based model to adjust national prevalence estimates. We included 103 articles for analysis. The global prevalence of pterygium was 8.22% (95% confidence interval (CI) = 5.31-12.43) in 2023, amounting to 552.85 million (95% CI = 356.93-835.74) cases. We observed that the prevalence increased with age, and that it did not differ substantially by sex, i.e. among men (8.36%; 95% CI = 5.40-12.63) and women (8.08%; 95% CI = 5.21-12.22). We found the highest regional prevalence of pterygium in low- and middle-income countries of the South-East Asia Region (13.52%; 95% CI = 8.98-19.65) in 2023, and the highest national prevalence in Saint Helena (22.57%; 95% CI = 11.79-39.47). Our analysis indicates that pterygium represents a substantial global burden that can progress to severe visual impairment if untreated. Targeted public health strategies are urgently needed to prevent pterygium-related vision loss worldwide. PROSPERO: CRD420251056115.