An Evaluation of Disease Burden and Prevalence of Glaucoma in Bangladesh: A National Population-Based Survey

Background: Glaucoma is the second leading cause of blindness worldwide. Being asymptomatic, a significant proportion of these patients do not present at the appropriate time. This study was carried out to estimate the epidemiology of glaucoma using a representative population-based sample across Bangladesh. This study also aimed to estimate the functional and quality-of-life burden associated with glaucoma in the country. Methods: A cross-sectional household survey was performed to identify the target population aged ≥35. A multi-stage stratified cluster random sampling was done to select households, the survey being conducted on 13,791 residential households, with 17,002 completed interviews. International Society for Geographic and Epidemiological Ophthalmology definitions were used to define glaucoma and glaucoma suspect cases. Results: 12,000 participants underwent detailed ophthalmic examination with a male-to-female ratio of approximately 1:1. A larger percentage (3.9%) of males were affected with glaucoma, compared to 2.5% of females (3.19%). In this study, 1206 patients (10.0%) were diagnosed as glaucoma suspect, with females (12.0%) comprising a majority over males (8.1%). Approximately 6% of patients had an occludable angle. Primary glaucoma comprised 94.6% of all diagnosed glaucoma, with normotensive glaucoma forming almost 83% of open-angle glaucoma. Conclusions: Survey estimates suggest that approximately 2 million adults may have glaucoma and nearly 6 million may be glaucoma suspects in Bangladesh. Primary open-angle glaucoma is far more common, affecting over four out of five patients, with males more affected. It found that glaucoma often impairs reading and seeing nearby objects, with nearly half of patients reporting difficulty walking in the dark.