Abstract
Objectives
To describe the demographic and clinical characteristics of inpatients with corneal blindness in China and identify independent risk factors.
Methods
This multicentre, retrospective, observational study was conducted by 16 clinical centres in 15 provincial-level administrative regions across China. Inpatients discharged with a primary diagnosis of corneal disease between January 1, 2019, and December 31, 2021, were included. The demographic and clinical characteristics of patients with corneal blindness were evaluated, and risk factors were identified via multivariate regression analysis. Regional variations in the corneal blindness and keratoplasty rates were also assessed.
Results
A total of 15,937 patients with corneal diseases were analysed; 9272 of these patients (58.18%) had corneal blindness. Most patients were male (6614 [71.33%]), with a median age of 55 years (IQR 45–66). The most common types of corneal blindness were keratitis (5141 [55.45%]) and corneal injury (3153 [34.01%]). Multivariate regression analysis revealed that male sex (aOR 1.171, 95% CI 1.081–1.268), older age (aOR 1.021, 95% CI 1.019–1.024), rural residence (aOR 1.348, 95% CI 1.254–1.448), lack of medical insurance (aOR 1.215, 95% CI 1.123–1.314), living in the western region (aOR 1.247, 95% CI 1.152–1.350) and having coexisting glaucoma (aOR 2.288, 95% CI 1.890–2.768) were risk factors for corneal blindness. The western region had the highest percentage of corneal blindness cases (p < 0.001, 61.23%) but the lowest percentage of keratoplasty cases (p < 0.001, 24.68%).
Conclusions
The study on identifying risk factors for corneal blindness provides evidence for optimising clinical decision-making and may contribute to reducing the incidence of corneal blindness.
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Data availability
The datasets generated during and/or analysed during the current study are available from the corresponding author upon reasonable request.
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Acknowledgements
We acknowledge all authors who have contributed to the work and authorship of this manuscript.
Funding
This work was supported by the National Key R&D Program of China [grant number 2019YFC0840708]; the Zhejiang Province Leading Geese Plan [grant number 2024C03206]; the Science and Technology Plan Project of Wenzhou Municipality [grant number Y20211005]; the Centralized Guided Local Science and Technology Development Funds Project of China [grant number ZYYD2024CG16]; the Ningbo Top Medical and Health Research Program [grant number 2023030716].
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WC, YC was responsible for designing the review protocol, writing the protocol and report; HX, XYZ were responsible for designing the review protocol, writing the protocol and report, analysing data, interpreting results and creating ‘Summary of findings’ tables; KXT, CXW, RFW, KSW, CHD, GC were responsible for analysing data, interpreting results, creating ‘Summary of findings’ tables and providing feedback on the report. JW, HL, QZ, BHC, JSX, HPL, FW, HD, TS, JZY, YNY, LMC, SZZ, ZRL, PCW, YNX, WQ, QX, YPH, LYH, HL, MY were responsible for collecting data and providing feedback on the report.
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Xie, H., Zhang, X., Tang, K. et al. Epidemiology and risk factors for corneal blindness in China: a multicentre retrospective study of 15,937 inpatients. Eye 40, 1005–1013 (2026). https://doi.org/10.1038/s41433-026-04311-9
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DOI: https://doi.org/10.1038/s41433-026-04311-9
