GLAUCOMA PREVALENCE IN INDIA

 

DR. SALEHA HASAN

MD (Community Medicine) PG resident,

Ajmal Khan Tibbiya College,

Aligarh Muslim University (AMU),

Aligarh, India

Community ophthalmology is a health-care modality promoting eye health and blindness prevention through initiatives that combine public health, community medicine, and holistic ophthalmic care approaches. Glaucoma is a significant cause of visual morbidity in India.

There are approximately 11.2 million persons aged 40 years and older with glaucoma in India.

The number of persons with Primary open-angle glaucoma (POAG) is estimated to be 6.48 (95% CI: 5.06-7.89) million.

Primary angle-closure glaucoma (PACG) affects an estimated 2.54 (95% CI: 1.88-4.28) million persons. Those with some evidence of damage—raised IOP, peripheral anterior synechiae or glaucomatous disc, or field changes comprise 6.62 (95% CI: 4.78-9.41) million persons. Those with any form of primary angle-closure disease could comprise 27.6 million persons. The prevalence of PACG and PAC show a linear increase with age.

The rates of ocular hypertension (OHT) show wide variations. Using the mean crude prevalence of 1.53% for OHT obtained from some studies conducted across India, an estimated 4.7 million persons could be ocular hypertensive.

Rates for secondary glaucoma are sketchily reported for the Indian population. They range from 0.08% to 1.39%. Crude estimates of those affected with secondary glaucoma, suggest around 2.28 million persons.

The proportion of those diagnosed to be bilaterally blind because of POAG in the APEDS, ACES, CGS (rural), CGS (Urban), and WBGS was 11.1%, 1.6%, 3.2%, 1.5%, and 5.2%, respectively. The corresponding figures for PACG for APEDS, CGS (rural), and CGS (Urban) were 16.6%, 2.9%, and 5.9%, respectively.

[Name key: Vellore Eye Survey (VES), Andhra Pradesh Eye Disease Study (APEDS), Aravind Comprehensive Eye Survey (ACES), Chennai Glaucoma Study (CGS), and West Bengal Glaucoma Study (WBGS).]

PACG on average produced 2 times the proportion of bilateral blindness than POAG.

These studies show that a community health approach to glaucoma is paramount in a country with a huge population, like India.

REFERENCE:

George R, Ve RS, Vijaya L. Glaucoma in India: estimated burden of disease. J Glaucoma. 2010 Aug;19(6):391-7. doi: 10.1097/IJG.0b013e3181c4ac5b. PMID: 20711029.