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Editors Selection IGR 16-3

Epidemiology: Newest data on Glaucoma prevalence in the US

Comment by Rupert Bourne on:

This meta-analysis is an advance on what we know of prevalence of glaucoma in the USA, the authors estimating that in 2022, 4 million people had glaucoma (all forms combined) with approximately 35% (1.5 million) of them with associated poor visual acuity or visual field damage. Glaucoma was estimated to affect 2.56% (95% Uncertainty Interval, UI, 2.10%-3.16%) among those 40 years or older, rising to 5.20% (UI, 4.12%-6.49%) among those aged 65 years or older.

In 2022 in USA, “4 million people had glaucoma ……”. It also is “estimated to affect 2.56% among those 40 years or older, rising to 5.20% among those aged 65 years or older.”

As with other meta-analyses, males were found to have higher age-standardised prevalence of glaucoma and vision-affecting glaucoma than females.^1,2 This recent meta-analysis incorporated data from the 2005-2008 National Health and Nutrition Examination Survey (NHANES)- a cross-sectional survey that uses a stratified multistage probability design to obtain representative health data of the civilian, noninstitu-tionalized US population.³ The NHANES oversamples elderly participants and certain age and minority groups, making it well suited to estimate glaucoma prevalence in the United States, and prior NHANES studies had relied on only self-reported glaucoma. By analysing optic nerve photographs from 5,746 participants, NHANES 2005-2008 reported a glaucoma prevalence of 2.1% (95% confidence interval [CI], 1.7%–2.6%) in the population aged 40 years and older, of whom half the cases were undiagnosed.⁴ In this current meta-analysis, the authors also used data from the Los Angeles Latino Eye Study (2000 to 2003);⁵ a meta-analysis by the Eye Diseases Prevalence Research Group (EDPRG; that analyzed studies conducted from 1985 to 2000);⁶ the Salisbury Eye Evaluation Glaucoma Study (2001-2003),⁷ and two medical claims databases. The authors acknowledge the limitations associated with differing glaucoma definitions between studies/sources. They report substantial variation in prevalence across US states and counties and in demographic subgroups, for example non-Hispanic black adults were approximately twice as likely as non-Hispanic white adults to have glaucoma and nearly 3 times as likely to have vision-affecting glaucoma after adjusting for age and sex/gender. In summary, this report demonstrates the importance of population-based data collection that quantifies the met and unmet need for glaucoma care. We eagerly await the imminent NHANES survey which will employ both optic disc photography and OCT which should provide additional insight into glaucoma trends in the US population.

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