Wills Glaucoma Service Foundation Lighthouse

THE WORLD-WIDE EFFECTS OF GLAUCOMA

Rohit Varma, MD, MPH

Cataract is the leading cause of Blindness in the world with over 30 million persons affected by it. The second leading cause in the past was trachoma. However, with improvements in prevention and treatment, trachoma is on the decline. In contrast, Glaucoma (Open-angle and Angle Closure) is currently the second leading cause of blindness and given the aging population in both the developed and developing world, the prevalence of Glaucoma is increasing. It is estimated, that in 2000, 66.8 million persons in the world have Glaucoma (Open angle and Angle Closure) and 7.6 million of them are bilaterally blind based primarily on visual acuity measurement. The level of disability associated with glaucoma due to unilateral blindness and peripheral field loss has not been evaluated carefully. This is particularly important since recent data suggest that restriction in activities of daily living and accidental falls are associated with visual field loss.

The following tables and figure provide some estimates of open angle glaucoma and angle closure glaucoma and are adapted from Elolia and Stokes (www.hc-sc.gc.ca/pphb-dgspsp/publicat/cdic-mcc/19-4/d_e.html). Age, gender and race/ethnicity specific data are also provided. These data have then been synthesized into worldwide estimates(2).

Table 1

Prevalence Rates of Open Angle Glaucoma in

Some Population-based Studies

Study (Year)	Age group	N	No of cases	Prevalence rate

Framingham, MA (1973–1975)	52–85	2433	28	1.4
Roscommon, Ireland (1990)	>50	2186	41	1.9
Casteldaccia, Italy (before 1992)	>40	1062	13	1.2
Ponza, Italy (1986)	>40	1034	26	2.5
Beaver Dam, WI (1988–1990)	43–84	4926	104	2.1
Baltimore, MD(1985–1988)	>40 White Black	5308 2913 2395	132 32 100	2.5 1.1 4.2
Barbados (1988–1992)	40–84, AC	4631	309	6.7
St. Lucia	>30	1679	147	8.8
Japan (1988–1989)	>40	8126	213	2.6
Mongolia (1995)	>40	942	5	0.5
Mamre, South Africa (1992)	>40	987	15	1.5
Blue Mountains, Australia (1992–1994)	>49	3654	108	3.0
Andhra Pradesh, India (1998-2000)	>30	1399	27	1.62
Melbourne, Australia	>40	3271	72	2.2
Tucson, AZ (1997-1999)	>40	4774	94	1.97

Table 2 Age-Specific Prevalence Rates of Open Angle Glaucoma

Study	Age group	Prevalence (%)
Baltimore, MD. (European)
	40–49	0.9
	50–59	0.4
	60–69	0.9
	70–79	2.9
	80+	2.2
	Total	1.3
Baltimore, MD (African- American)
	40–49	1.2
	50–59	4.1
	60–69	5.5
	70–79	9.2
	80+	11.3
	Total	4.7
Barbados	40–49	1.4
	50–59	4.1
	60–69	6.7
	70–79	14.8
	80+	23.2
	Total	6.8
Andhra Pradesh, India	30-39	0.22
	40-49	1.26
	50-59	2.31
	60-69	4.89
	70+	6.32
	Total	1.62
Tucson, AZ	41-49	0.5
	50-59	0.59
	60-69	1.73
	70-79	5.66
	80-89	12.02
	90+	20
	Total	1.97
Japan	30–49	1.0
	50–69	2.6
	70+	5.3
	Total 2.5

TABLE 3 Prevalence of primary angle-closure glaucoma
Study (Year)	Age group	N	No of cases	Crude prevalence (%)
Beaver Dam, US (1988–1990)	43–84	4926	2	0.04
Roscommon, Ireland (1990)	50+	2186	2	0.01
Mamre, South Africa (1992)	40+	987	23	2.30
Japan (1988–1989)	40+	8126	28	0.34
Doumen, China (1990)	45+	932	6	0.64
Mongolia (1995)	40+	942	14	1.40
Alaskan Inuit (1985)	40+	377	10	2.65
Copenhagen, Inuit women (1978)	40+	63	2	3.20
Greenland Inuit (1969)	40+	344	21	6.10

TABLE 4 Prevalence of primary angle-closure glaucoma by age and sex
Study (Year)	Age	Prevalence (%)
Study (Year)	Age	Men	Women
Mongolia (1995)	40–49	0.0	0.8
	50–59	0.8	1.3
	60–69	2.5	4.9
	70+	7.5	0.0
Japan (1988-1989)	40+	1.5	1.5
	30–49	0.0	0.0
	50–69	0.17	0.49
	70+	0.70	0.85
Mamre, South Africa (1992)	30+	0.21	0.38
	40–49	0.0	1.5
	50–59	1.0	0.7
	60–69	2.3	5.2
	70+	2.3	11.9
Alaskan Inuit (1986–1987)	40+	1.0	3.2
	<50	0.0	0.0
	50–59	3.1	3.6
	60–69	2.6	11.8
	70+	3.7	11.8
Alaskan Inuit (1985)	40+	2.1	5.5
Alaskan Inuit (1985)	50+	0.24	0.94
Greenland Inuit (1969)	40+	1.9	9.9
Doumen, China (1990)	45+	0.3	0.3

TABLE 5 Estimated ratio of primary open-angle glaucoma to primary angle-closure glaucoma by race
Racial origin	Ratio
China	2:3
India	1:1
South Asia	1:1
Europe	11:1
Africa	152:1
Latin America	2:1
Near East	2:1

Figure 1

Estimated Age, Gender, and Race/Ethnicity Specific Prevalence Rates (%)

For Open-Angle Glaucoma in the U.S.

Source: www.nei.nih.gov/eyedata/tables.htm

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