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Prevalence of glaucoma in the Australian National Eye Health Survey
  1. Stuart Keel1,
  2. Jing Xie1,
  3. Joshua Foreman1,2,
  4. Pei Ying Lee1,
  5. Mostafa Alwan1,
  6. Eamonn T Fahy1,
  7. Peter van Wijngaarden1,2,
  8. Jennifer C Fan Gaskin1,
  9. Ghee Soon Ang1,
  10. Jonathan G Crowston1,2,
  11. Hugh R Taylor3,
  12. Mohamed Dirani1,4
  1. 1 Centre for EyeResearch Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital & Melbourne, Australia
  2. 2 Department of Surgery, University of Melbourne, Melbourne, Australia
  3. 3 Indigenous Eye Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
  4. 4 Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
  1. Correspondence to Dr Stuart Keel, Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne 3002, Australia; stuart.keel{at}unimelb.edu.au

Abstract

Aim To estimate the prevalence of glaucoma in Australia.

Methods This was a population-based study of 3098 non-Indigenous Australians (50–98 years) and 1738 Indigenous Australians (40–92 years) stratified by remoteness. Each participant underwent a standard examination that included visual field assessment, tonometry and non-mydriatic fundus photography. Two fellowship-trained glaucoma specialists independently assessed relevant case notes (past ocular history, best-corrected visual acuity, frequency doubling technology visual fields, Van Herick grade, intraocular pressure and optic disc-centred photographs) and assigned a diagnosis ranked on a scale of certainty: none, possible, probable or definite glaucoma.

Results A total of 4792 (99.1%, 3062 non-Indigenous and 1730 Indigenous) participants had retinal photographs in at least one eye that were gradable for glaucoma. The weighted prevalence of glaucoma (definite) in non-Indigenous Australians and Indigenous Australians was 1.5% (95% CI 1.0 to 2.2) and 0.6% (95% CI 0.4 to 1.1), respectively. When definite and probable cases of glaucoma were combined, rates were 3.4% (95% CI 2.7 to 4.3) among non-Indigenous and 1.6% (95% CI 1.1 to 2.3) in Indigenous Australians. Only 52.4% of non-Indigenous Australians and 28.0% of Indigenous Australians with glaucoma self-reported a known history of glaucoma.

Conclusion We estimate that 198 923 non-Indigenous Australians aged 50 years and over and 2139 Indigenous Australians aged 40 years and over have glaucoma. Given the high rates of undiagnosed glaucoma coupled with a significant ageing of the Australian population, improvements in case detection and access to low vision rehabilitation services may be required to cope with the growing burden of glaucoma.

  • epidemiology
  • public health
  • glaucoma

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Footnotes

  • Contributors All the authors have contributed to the planning, conduct and reporting of the work described in the article.

  • Funding The National Eye Health Survey was funded by the Department of Health of the Australian Government, and also received financial contributions from Novartis Australia and the Peggy and Leslie Cranbourne Foundation. This work was supported by the Department of Health of the Australian Government, an NHMRC Career Development Fellowship (#1090466, MD), the Peggy and Leslie Cranbourne Foundation and Novartis Australia. The Centre for Eye Research Australia receives Operational Infrastructure Support from the Victorian Government.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The protocol was approved by the Royal Victorian Eye and Ear Hospital Human Research Ethics Committee (HREC-14/1199H) as well as state-based Indigenous ethics organisations.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The datasets generated during and/or analysed during the current study may be available from the corresponding author on reasonable request.

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