Purpose To explore the trends in worldwide ophthalmic research production over a 21-year period in relation to journals, contributing countries and dominating topics with special focus on the Nordic region. Methods Articles published between 2000 and 2020 in 20 top-ranked ophthalmology journals were included. Number of articles and impact points were measured per country for each year. The most frequently occurring keywords were calculated worldwide and for the top five contributing countries and the Nordic countries. Trends were explored using linear regression. Results The analysis included 65 220 articles. Linear regression showed an increase with 56 articles per year (beta = 56.3, R-2 = 0.72, p-value < 0.01). The United States published the most articles, comprising 35% of the worldwide total, followed by the United Kingdom (9%) and Japan (7%). Population-adjusted productivity revealed that Iceland was the most prolific country with 10 articles per million inhabitants/year. Singapore was second and Denmark third with corresponding numbers of nine and seven. Analysing regional trends, Asia had the largest increase in yearly number of articles (beta = 29.1, R-2 = 0.89, p-value < 0.01). The strongest positive trend was observed in China (beta = 15.7, R-2 = 0.94, p-value < 0.01). The Nordic countries contributed with 3.6% of worldwide ophthalmological papers. Among these, Denmark was the only country with a significant positive trend in impact points per million inhabitants per year (beta = 0.6, R-2 = 0.54, p-value < 0.01). The most frequently occurring eye disease within the whole time frame was myopia (5.8%) followed by macular degeneration (5.4%) and glaucoma (5.3%). Linear regression showed a significant increase in the proportion of articles about diabetic retinopathy (beta = 0.2%, R-2 = 0.88, p-value < 0.01) a significant decrease in the proportion in articles about cataract (beta = -0.1%, R-2 = 0.70, p-value < 0.01) and myopia (beta = -0.1%, R-2 = 0.67, p-value < 0.01). Conclusions The worldwide ophthalmic research productivity has maintained a growing trend from 2000 to 2020. While North America and Europe are the major contributors, the scientific activity in Asia and especially China is growing impressively. With the current progress, Asia is forecast to outweigh Europe in 2025 and North America in 2033. Diabetic retinopathy was the most common eye disease in ophthalmologic papers in 2020, and also the topic with the strongest positive trend during 2000-2020.