Elsevier

Ophthalmology

Volume 105, Issue 4, 1 April 1998, Pages 733-739
Ophthalmology

The prevalence of glaucoma in the melbourne visual impairment project

https://doi.org/10.1016/S0161-6420(98)94031-3Get rights and content

Abstract

Purpose

The purpose of the study was to determine the prevalence of glaucoma in Melbourne, Australia.

Methods

All subjects were participants in the Melbourne Visual Impairment Project (Melbourne VIP), a population-based prevalence study of eye disease that included residential and nursing home populations. Each participant underwent a standardized eye examination, which included a Humphrey Visual Field test, applanation tonometry, fundus examination including fundal photographs, and a medical history interview. Glaucoma status was determined by a masked assessment and consensus adjudication of visual fields, optic disc photographs, intraocular pressure, and glaucoma history.

Results

A total of 3271 persons (83% response rate) participated in the residential Melbourne VIP. The overall prevalence rate of definite primary open-angle glaucoma in the residential population was 1.7% (95% confidence limits = 1.21, 2.21). Of these, 50% had not been diagnosed previously. Only two persons (0.1%) had primary angle-closure glaucoma and six persons (0.2%) had secondary glaucoma. The prevalence of glaucoma increased steadily with age from 0.1% at ages 40 to 49 years to 9.7% in persons aged 80 to 89 years. There was no relationship with gender. The authors examined 403 (90.2% response rate) nursing home residents. The age standardized rate for this component was 2.36% (95% confidence limits = 0, 4.88).

Conclusion

The rate of glaucoma in Melbourne rises significantly with age. With only half of patients being diagnosed, glaucoma is a major eye health problem and will become increasingly important as the population ages.

Section snippets

Methods

The Melbourne Visual Impairment Project (Melbourne VIP) is a population-based prevalence study of the distribution and determinants of eye disease in Melbourne, Australia. The methods have been described in detail previously.15 Melbourne is Australia’s second largest city, with a population in 1991 of 3.02 million.16 Other than those born in Australia (68%), Melbourne’s major cultural groups are from the United Kingdom (6%), Italy (3.1%), Greece (2.1%), Vietnam (1.5%), and New Zealand (1.2%).16

Residential group

A total of 3271 persons attended the Melbourne VIP, an 83% response rate. A comparison between participants and nonparticipants showed that they were similar in all aspects except that non-English—speaking persons were slightly less likely to attend.20

Of the 3271 persons, 6 did not have complete information on IOP, C/D ratios, visual fields, or glaucoma history and therefore were excluded. This left 3265 for analysis. Data were missing on visual fields for 23 persons, for IOP in 50 persons, and

Discussion

The overall prevalence of definite POAG cases in persons older than 40 years of age in the Melbourne VIP was 1.7% (95% CL = 1.21, 2.21). This rate is similar to other prevalence studies around the world (Table 6).

It has been noted that blacks have a higher rate of POAG than whites,3, 4 and it can be seen that the studies with the two highest overall rates of POAG8, 13 included large black populations. However, this is not the case in a study in South Africa that included many indigenous

Acknowledgements

The authors thank Carl Zeiss Pty Ltd. for their donation of the visual field analyzer, automatic refractor, and lens analyzer. The authors also thank Cara Jin, Sharon Lee, Marie Bissinella, Caroline De Paola, Juanita Kidd, Charles Guest, Sharon Bailey, Cathy Walker, Claire McKean, Dr. Julian Rait, Professor Paul Mitchell, Dr. Ivan Goldberg, Dr. Laurie Hirst, and Dr. Paul Healy.

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    Supported by the Victorian Health Promotion Foundation, Melbourne, the Ansell Ophthalmology Foundation, Melbourne, the National Health & Medical Research Council, Canberra, the Ophthalmic Research Institute of Australia, Sydney, Dorothy Edols Estate, Melbourne, and Carl Zeiss Pty Ltd, Sydney, Australia.

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