Glaucoma Global Burden Remains Substantial

It comes as no surprise that glaucoma is the leading cause of irreversible blindness worldwide, which is why researchers of a recent study aimed to shed light on the global, regional and national trends of this condition’s burden—specifically, among adults aged 45 and older between 1990 and 2021. They found accelerated declines that coincided with key therapeutic advances, but overall, the number of affected individuals increased—underscoring the need for targeted screening programs and public awareness campaigns emphasizing regular eye exams for early detection, they say. The findings were reported in Advances in Ophthalmology Practice and Research. This chart from the study shows the global decline in per capita glaucoma prevalence, which somewhat lines up with advances in medical interventions, such as the launch of prostaglandin analogs in the 1990s. The last leg of the chart (2019 to 2021) is likely spurious due to the pandemic’s effects on patient visits and data collection. Photo: Wu C, et al. Advances in Ophthalmology Practice and Research. June 16, 2026. Click image to enlarge. Data was obtained from the Global Burden of Disease 2021 study. Prevalence and disability-adjusted life-years (DALYs) for glaucoma were analyzed by age, sex, region and Sociodemographic Index (SDI), a composite measure of a country’s standing on various developmental milestones such as income and education level. The researchers explored trends and country-level performance.Globally, prevalence per 100,000 population declined from 116.29 to 90.12  and disability-adjusted life-years (DALYs) decreased from 13.37 to 9.05. However, the absolute number of glaucoma cases increased by 86.3% (from 4.07 million in 1990 to 7.59 million in 2021). “This pattern—declining age-standardized rates alongside rising absolute burden—reflects the dual impact of improved disease management and demographic aging,” the authors wrote in their paper. “For a given age, glaucoma burden has decreased over time. Advances in screening, diagnosis and treatment—including medications, laser therapy and surgery—have contributed to better intraocular pressure control and delayed disease progression.” However, they added, because glaucoma risk increases exponentially with age, the absolute number of older adults has outpaced these per-age improvements, leading to rising total cases.Five significant trend changes were identified, occurring in 1994, 2001, 2006, 2010 and 2019. The accelerated decline around 2001 coincides with the global expansion of prostaglandin analogs, particularly latanoprost, which was approved by the FDA in 1996.The sharp decline in prevalence between 2019 and 2021 is considered a data artifact caused by pandemic-related healthcare disruptions rather than a genuine reduction in disease burden, the authors noted in their paper.The largest decline in prevalence (2021) was seen in adults aged 90 to 94—more than 800-fold higher than those aged between 45 and 49, underscoring the need for age-tailored screening strategies, with particular focus on the oldest-old population. Additionally, men consistently showed a higher burden than women, likely reflecting the predominance of open-angle glaucoma in men.SDI showed a strong negative correlation with glaucoma burden, but several middle- and high-SDI countries exhibited excess burden relative to their development level. “These findings confirm that glaucoma epidemiology is not monochromatic; while SDI exerts significant influence, it is modulated by a constellation of latent variables—from environmental and genetic susceptibilities to the architecture of local healthcare systems,” the authors explained in their paper. For instance, Taiwan had some of the best numbers, likely reflecting its advanced universal health insurance system, high urbanization and widespread access to ophthalmic care. Additionally, a study of the Amis aboriginal population in Taiwan reported an exceptionally low glaucoma prevalence (1%), suggesting that unique genetic protective factors may also contribute to the low observed burden in this population. “Therefore, integrating SDI with additional data sources—such as per capita GDP, educational attainment, healthcare system efficiency and genetic susceptibility—will help further elucidate the deep mechanisms underlying regional disparities in glaucoma burden,” the authors wrote.Sub-Saharan Africa recorded the highest burden, while high-SDI regions had the lowest. East Asia experienced the most substantial declines, which “suggests that, alongside genetic susceptibility, healthcare access and environmental factors play important roles in shaping regional disparities,” the paper continues.In conclusion, despite improvements in per-age glaucoma management, population aging continues to drive an increase in the total number of affected individuals. “These findings underscore the need for targeted screening programs and public awareness campaigns emphasizing the importance of regular eye examinations for early detection, particularly among elderly populations who bear the highest risk,” the authors concluded in their paper.Click here for the journal source. Wu C, Cao F, Chu B, et al. Global, regional and national trends in glaucoma burden among adults aged 45 years and older, 1990-2021. Advances in Ophthalmology Practice and Research. June 16, 2026. [Epub ahead of print.] This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.