Aging population contributes to rising glaucoma burden around the world
Reducing the occurrence of glaucoma poses a challenge around the world, with nearly 8 million people bilaterally blind from the disease. That number is estimated to increase over the next 10 years as the population ages.
“The actual prevalence of the disease is rising not because the incidence is rising, but because the population at risk is increasing,” Harry A. Quigley, MD, of Wilmer Eye Institute at Johns Hopkins University, said. “For example, in China, the proportion of people who are of the age to get glaucoma is expanding dramatically. In India, in South Asia, it’s expanding dramatically. People are living longer. It isn’t that the disease is becoming more common, it’s that the people who get it are becoming more common.”
Glaucoma is the No. 2 cause of blindness in the world, behind only cataracts. However, glaucoma is the leading cause of irreversible blindness. An estimated 8.4 million people worldwide will be bilaterally blind from glaucoma in 2010. By 2020, that number is estimated to rise to 11.1 million.
The key to preventing blindness from glaucoma is effective diagnosis and treatment for at-risk patients in developed and developing countries. But treating the disease is a challenge in some areas, including China, India and Africa, where patients are often undiagnosed or do not have access to care or affordable care.
A total of 60.5 million people worldwide will have open-angle glaucoma and angle-closure glaucoma in 2010, and by 2020, an estimated 79.6 million people will have the disease, Dr. Quigley and Aimee T. Broman, MA, found in a study published in the British Journal of Ophthalmology in 2006.
Harry A. Quigley, MD, of the Wilmer Eye Institute at Johns Hopkins University, attributes the rise in glaucoma prevalence to the increased number of at-risk patients.
In 2010, China is expected to have the highest number of patients with open-angle glaucoma and angle-closure glaucoma, followed by Europe and India, Dr. Quigley and Ms. Broman found. Africa will have the highest ratio of glaucoma-to-adult population. India will have the most detectable change in increase of the disease worldwide and will surpass Europe in 2020 in number of cases, the researchers estimated.
About 2.2 million Americans 40 years and older have glaucoma, according to an estimate by Friedman and colleagues in 2004. By 2010, about 2.79 million people in the U.S. will likely have open-angle glaucoma, Dr. Quigley and Ms. Broman found.
In the U.S. and other developed countries, rates of glaucoma are rising as the population ages. In the next 25 years, the American population older than 65 years is expected to double to 72 million people. Because the fastest growing population in developed countries is people older than 80 years, and because age is a major risk factor for the disease, the rate of glaucoma will continue to increase in the next 20 years, Ivan Goldberg, MBBS, FRANZCO, FRACS, a clinical associate professor at the University of Sydney, Australia, said.
“You’ve got a disease that is exponentially increasing in its prevalence with increasing age, and you’ve got an exponentially increasing graying of the population,” Dr. Goldberg said. “You put the two curves together, you realize that glaucoma is becoming an ever-increasing challenge.”
Around the world, the burden of glaucoma affects daily lives, Rupert Bourne, BSc, FRCOphth, MD, said.
“In day-to-day life, suffering from glaucoma has a major impact on one’s ability to function,” Dr. Bourne, who co-directs the Vision and Eye Research Unit in Cambridge, England, said. “There are an enormous number of people with it. It has a significant impact on quality of life even when of moderate severity, and its irreversibility makes this a major public health problem.”
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