Glaucoma study shows higher prevalence than previously estimated

Adapted from Prevent Blindness/IHME

A new study on the prevalence of glaucoma in the United States as of 2022, published in JAMA Ophthalmology, found that approximately 4.22 million people in the United States have glaucoma (1.62% of adults), and 1.49 million people (0.57% of adults) have vision-affecting glaucoma, with substantial variation in prevalence across demographic subgroups, U.S. states, and counties. 

Among those ages 40 and older, 2.56% have glaucoma and 0.91% have vision-affecting glaucoma. 

Previous estimates of glaucoma prevalence published in 2016 were 2.1% of adults ages 40 years and older and did not include estimates for those under 40 years old, or estimates of vision-affecting glaucoma.

This study leverages new multi-source, composite estimates of the prevalence of glaucoma and vision-affecting glaucoma in the US for individuals aged 18 and older.

Glaucoma is a group of eye diseases which cause loss of sight by damaging the optic nerve. Vision loss begins in periphery, or side vision, and can progress to total vision loss without successful treatment. 

At present, any vision lost to glaucoma cannot be regained. Vision loss due to glaucoma is also associated with disability, loss of independence, and declines in overall health and wellbeing. Because there are often no early symptoms, half of people with glaucoma do not know they have the eye disease, according to CDC.

Although there is no cure for glaucoma, early detection and treatment may prevent or delay permanent vision loss. 

“Up-to-date estimates of how many people have glaucoma in a certain area are vital for addressing the problem. This kind of information is important for formulating evidence-based policy and public health solutions,” said Joshua Ehrlich, M.D., M.P.H., first author of the study and an associate professor in the Department of Ophthalmology at the University of Michigan Medical School and the U-M Institute for Social Research. His work on the project was made possible by the Vision Health Initiative of the federal Centers for Disease Control and Prevention.

Additional key findings from the study include:

• Black individuals are about three times as likely to have vision-affecting glaucoma as white individuals.

• An estimated 1.94 million individuals with male sex/gender and 2.29 million individuals with female sex/gender are living with glaucoma.

• One in about 180 adults have vision loss from glaucoma, with risk increasing with age. 
• Rates of glaucoma vary by location, with Mississippi having the highest glaucoma prevalence rate (1.95 percent), and Utah the lowest (1.11 percent).

While the study identifies populations at increased risk of glaucoma, additional factors that contribute to vision loss from glaucoma include limited access to eye care, inability to afford necessary treatments, presence of other chronic conditions, family history of glaucoma, and inadequate education about the disease, causes, and need for early intervention. 

The updated prevalence estimates provided by this study can help inform the development, prioritization, and evaluation of public health strategies to address glaucoma, allocate resources, and tailor public health strategies to the groups most affected, the authors note.

“These new glaucoma prevalence data can help inform policy planning related to vision health and will be valuable as states and localities work to support their aging populations,” said John D. Omura, M.D., a co-author of the study and a medical officer at CDC.

Study estimates were developed using data within CDC’s Vision and Eye Health Surveillance System (VEHSS).

The VEHSS uses new and existing data sources to help health professionals, researchers, policy makers and patients understand the scope of vision loss, eye disorders, and eye care services in the United States.

“These estimates mark the fourth set of national, state, and county level estimates created by the Vision and Eye Health Surveillance System, joining previously published estimates of vision impairment and blindness, age-related macular degeneration, and diabetic retinopathy. Collectively, these estimates expand our understanding of which Americans experience vision loss, blindness and the major diseases that cause vision problems,” said David. B. Rein, Ph.D., principal investigator of VEHSS, and senior fellow at NORC at the University of Chicago.

“To estimate the national prevalence of glaucoma and vision-affecting glaucoma, we used methods developed as part of the Global Burden of Disease Study, which is the most comprehensive study of its kind. These estimates are critical to understand the impact of glaucoma, how trends are changing, and how policymakers can take action with these results,” said Abraham Flaxman, Ph.D. associate professor at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, who led the statistical modeling on the paper.

“The data from the ‘Prevalence of Glaucoma in the U.S. in 2022’ study demonstrates that now, more than ever, is the time to dedicate resources to help the growing number of glaucoma patients obtain access to eye care to help save vision from the ‘Silent Thief of Sight,’” said Jeff Todd, president and CEO of Prevent Blindness, a nonprofit organization that is providing dissemination support for the report.

For more information on the “Prevalence of Glaucoma in the U.S. in 2022” study or the VEHSS, visit https://www.cdc.gov/vision-health-data/. For information on glaucoma, please visit PreventBlindness.org/glaucoma.  

Funding for this study was provided by the CDC Vision Health Initiative via cooperative agreement NU58DP007190, “Improving and Enhancing the US Vision and Eye Health Surveillance System.”