A comprehensive global analysis of eye health research published between 2000 and 2019 has revealed that the volume of peer-reviewed primary research doubled during those two decades, yet substantial inequalities in research output and authorship remain. The findings, published in BMJ Open Ophthalmology and led by ICEH researchers, offer a new evidence base for understanding how eye health science has evolved and where gaps continue to exist.

The team conducted a bibliometric analysis of all primary eye health research indexed in major biomedical databases over the period. They identified 158,697 publications from 178 countries, covering population, clinical, animal and laboratory studies related to vision and eye disease. Over the study period, annual research output grew from about 5,000 articles in 2000 to nearly 11,000 in 2019, corresponding to an average increase of roughly 4.2% per year.

Despite this growth, the geographic distribution of research was highly unequal. Approximately 70% of all publications originated in high-income countries, with much lower output per capita in regions such as Central Sub-Saharan Africa. For example, research output ranged from about 1 paper per million population in Central Sub-Saharan Africa to over 165 per million in Australasia.

The study also examined gender representation among authors using a validated algorithm. Among 789,463 authorships where gender could be assigned, women accounted for 33% of all authors, with higher representation among first authors (36%) but lower among last (senior) authors (24%). When women were listed as the last author, research teams were more likely to be gender-balanced compared with teams where the last author was male.

About 42% of research publications focused on the five leading causes of vision impairment (uncorrected refractive error, cataract, AMD, glaucoma and diabetic retinopathy), suggesting some alignment between research activity and major clinical burden, although large gaps remain.

The authors conclude that although global eye health research volume has expanded substantially, persistent geographic and gender imbalances hinder equity in scientific contribution and knowledge generation. Strengthening research capacity in underrepresented regions and supporting diversity among investigators will be crucial steps to ensure that eye health research reflects global needs.

Publication

Ramke J, Chugtai S, Bezaras J et al. Research on eye health 2000-2019: a global bibliometric analysis with a focus on equity. BMJ Open Ophthalmology. February 2026. https://doi.org/10.1136/bmjophth-2025-002404