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Background To estimate the global, regional and national burdens of blindness and vision loss among children and adolescents from 1990 to 2021, categorised by age, severity and cause, and to project the burdens through 2030.Methods Based on the Global Burden of Diseases, Injuries and Risk Factors Study 2021, the burden of blindness and vision loss was evaluated by case numbers, rates per 100 000 population and average annual percentage changes (AAPCs) in prevalence and years lived with disability (YLD) rates. The burden of trends from 1990 to 2021 was analysed using a joinpoint regression model, and the Bayesian age-period-cohort (BAPC) model projected the disease burden through 2030.Results Globally, there was no significant change in the prevalence rate of blindness and vision loss from 1990 to 2021, but the YLD rate significantly decreased (AAPC −0.17). The prevalence and YLD rates declined for refraction disorders and other vision loss from 1990 to 2021 but increased for near vision loss. The prevalence and YLD rates of refractive disorders show the most significant increase in East Asia. The BAPC model forecasts a rise in global blindness and vision loss prevalence and the YLD from 2021 to 2030 (1.63% and 0.03%, respectively), although refraction disorders and other vision loss are expected to decline.Conclusions Over the past three decades, global efforts have reduced the burden of blindness and vision loss among children and adolescents. Despite the overall decrease in refraction disorders, East Asia remains a challenge.