Study Suggests Glaucoma-Induced Vision Loss is on the Rise

Rupert Bourne, MD

New data of 20-year trends show a decreasing prevalence of age-adjusted glaucoma blindness but an increasing prevalence of moderate and severe vision loss due to glaucoma. These findings were presented at the Association for Research in Vision and Ophthalmology (ARVO) Virtual Meeting.

The analysis, led by Rupert Bourne, MD, of Vision & Eye Research Institute, Cambridge, UK, utilized data from population-based surveys conducted between January 1980 – October, 2018. Data through 2020 were also included in the analysis.

In order to capture temporal and geographic changes in glaucoma prevalence, they used hierarchical models to estimate prevalence of moderate and severe vision impairment (defined as visual acuity from <6/18 – 3/60). They also identified prevalence of blindness caused by glaucoma (visual acuity, <3/60), stratifying them by age, sex, region, and year.

Thus, Bourne and colleagues reported that a total of 3.60 million (95% CI, 2.80-4.41) individuals ≥50 years of age presented with blindness from glaucoma in 2020—representing a 41.0% increase since 2000. 

Even more, 4.13 million (95% CI, 3.24-5.17) individuals had cases of moderate and severe vision impairment—representing a 91.9% increase over the same 20-year time span.

However, age-standardized prevalence of glaucoma blindness decreased by 23.3%; moderate and severe vision impairment increased by 5.9%.

The team also indicated that the age-standardized ratio of women to men for glaucoma blindness in 2020 was 0.71:1.00. For 2000, this was 0.67:1.00. 

The ratio for moderate to severe vision impairment was 0.87:1.00 in 2020 and 0.84:1.00 in 2000.

In terms of geographic patterns, Sub-Saharan African presented with the highest rates in 2020 for age-standardized glaucoma blindness (0.66%; 95% CI, 0.52-0.81) and vision impairment (0.46%; 95% CI, 0.36-0.57) in individuals ≥50 years of age.

Regions with high rates of both conditions were North Africa and Middle East (blindness: 0.57%; 95% CI, 0.44-0.71; vision impairment: 0.38%; 95% CI, 0.29-0.48) as well as Latin America and the Caribbean (blindness: 0.26%; 0.20-0.32; vision impairment: 0.39%; 95% CI, 0.30-0.48).

“The decline in age-adjusted glaucoma blindness suggests successful targeting of the most severe cases or earlier detection,” the investigators wrote. “Further reduction in the burden of vision impairment from glaucoma can be realised by improved access and affordability of topical medications and laser, and a focus on high quality glaucoma surgery and postoperative care”

They empathized the importance of sustainability and cost-effectiveness of screening; however, implementing such strategies may prove difficult for certain populations. Nonetheless, they stressed a need for increased glaucoma awareness across families, in primary care settings, and in eyecare programs to stem the rise of glaucoma-induced irreversible vision loss.

The study, “Burden of Global Vision Loss due to Glaucoma: Temporal and Regional Changes 2000-2020,” was presented at ARVO 2021.