Change in Glaucoma Prevalence, Age 40 and Older

Glaucoma is a disease that causes a gradual degeneration of cells that make up the optic nerve, which carries visual information from the eye to the brain. As the nerve cells die, vision is slowly lost, usually beginning in the periphery. Often, the loss of vision is unnoticeable until a significant amount of nerve damage has occurred. For this reason, as many as half of all people with glaucoma may be unaware of their disease. 

The exact cause of primary open-angle glaucoma, the most common form of the disease, is uncertain. Other forms of glaucoma (such as angle-closure, secondary and congenital glaucoma) occur in relation to specific physical causes. 

Elevated fluid pressure within the eye (intraocular pressure) seems related in some way to all cases of glaucoma. The majority of cases of glaucoma exhibit intraocular pressure outside normal limits at some time. However, even those cases with apparently normal pressure seem to benefit from treatment aimed at lowering pressure. 

Most cases of glaucoma can be controlled and vision loss slowed or halted by treatment. Medications, laser treatments and surgery can be used to lower intraocular pressure. However, any vision lost to glaucoma cannot be restored. 

Unfortunately, glaucoma cannot be prevented. Factors that increase the risk of glaucoma include age, race, diabetes, eye trauma and long-term use of steroid medications. 

Glaucoma is traditionally defined by a triad of signs, including the presence of at least two of the following: elevated intraocular pressure, optic disc cupping and visual field loss. However, case definitions used in the various epidemiologic studies of the disease have differed on specific criteria. Only cases of primary open-angle glaucoma  that had clear signs of optic nerve head damage and/or reproducible visual field loss (definite open-angle glaucoma) are included in the prevalence estimates. These prevalence estimates include diagnosed and undiagnosed glaucoma in the United States.

The Vision Problems in the U.S. database provides state-by-state prevalence estimates for glaucoma by age, race and sex. Glaucoma affects more than 2.7 million Americans age 40 and older, or about 1.9% of this population. Glaucoma prevalence is clearly related to age and race. In general, glaucoma is more common in Blacks, Hispanics and with increasing age.