Perspective
An Assessment of the Health and Economic Burdens of Glaucoma

https://doi.org/10.1016/j.ajo.2011.06.004Get rights and content

Purpose

To bring together information concerning the epidemiology and the economic and individual burdens of glaucoma.

Design

Interpretive essay.

Methods

Review and synthesis of selected literature published from 1991 through December 2010.

Results

An estimated 3% of the global population over 40 years of age currently has glaucoma, the majority of whom are undiagnosed. Vision loss from glaucoma has a significant impact on health-related quality of life even in the early stages of disease. The overall burden increases as glaucomatous damage and vision loss progress. The economic burden of glaucoma is significant and increases as the disease worsens.

Conclusions

Early identification and treatment of patients with glaucoma and those with ocular hypertension at high risk of developing vision loss are likely to reduce an individual's loss of health-related quality of life as well as the personal and societal economic burdens.

Section snippets

Methods

Publications in English from 1991 through December 2010 on the topics of the epidemiology, economic burden, and individual burden of glaucoma were reviewed. In addition to author identification of important articles, Medline searches (and Embase and IPD for epidemiology) were conducted to identify additional relevant articles using combinations of keywords with “glaucoma” including “prevalence,” “incidence,” “epidemiology,” “cost,” “resource,” and “quality of life.” Searches were intended to

Epidemiology

The prevalence of glaucoma is increasing worldwide (Figure 2).1 Globally, an estimated 60.5 million people (2.65% of the global population over 40) suffered from glaucoma in 2010. Of these, an estimated 44.7 million had primary open-angle glaucoma (POAG) and 15.7 million primary angle-closure glaucoma (PACG). The prevalence of glaucoma is expected to reach 79.6 million in 2020, impacting all countries, although the largest increases are expected to be in China and India, which together will

Economics of Glaucoma

The prevalence of glaucoma contributes to significant costs that are both direct and indirect.13 Direct medical costs include ocular hypotensive medication(s), physician and hospital visits, and glaucoma-related procedures while direct nonmedical costs include transportation, government purchase programs, guide dogs, and nursing home care. Indirect costs reflect lost productivity, such as days missed from work, and can include the productivity costs borne by caregivers such as family members

Individual Burden of Glaucoma

Glaucoma impacts patients' health-related quality of life (HRQoL) in multiple ways, including driving, walking, and reading. The psychological burden increases as vision decreases, along with a growing fear of blindness, social withdrawal from impaired vision, and depression. The components of a good HRQoL differ among individuals, but having enough visual ability is a high priority. HRQoL is a concept that reflects a person's well-being and that focuses on dimensions of physical functioning,

Comment

Glaucoma is common, on the rise, underdiagnosed, costly, distressing to those affected and their families, and disabling. As the population increases, so does the absolute number of glaucoma sufferers. In addition, with glaucoma prevalence increasing exponentially with age, glaucoma numbers are rising with the rapidly aging population. Glaucoma patients are estimated to rise in number from 60 million in 2010 to nearly 80 million in 2020, with more than half in developed societies remaining

References (35)

  • E.E. Freeman et al.

    Glaucoma and quality of life: the Salisbury Eye Evaluation

    Ophthalmology

    (2008)
  • R. Varma et al.

    Impact of severity and bilaterality of visual impairment on health-related quality of life

    Ophthalmology

    (2006)
  • H.A. Quigley et al.

    The number of people with glaucoma worldwide in 2010 and 2020

    Br J Ophthalmol

    (2006)
  • D.S. Friedman et al.

    An evidence-based assessment of risk factors for the progression of ocular hypertension and glaucoma

    Am J Ophthalmol

    (2004)
  • D.S. Friedman et al.

    Prevalence of open-angle glaucoma among adults in the United States

    Arch Ophthalmol

    (2004)
  • D.S. Friedman et al.

    The prevalence of open-angle glaucoma among blacks and whites 73 years and older: the Salisbury Eye Evaluation Glaucoma Study

    Arch Ophthalmol

    (2006)
  • J.M. Tielsch et al.

    Racial variations in the prevalence of primary open-angle glaucomaThe Baltimore Eye Survey

    JAMA

    (1991)
  • Cited by (295)

    • Evaluation of an experiment in ophthalmology telemedicine

      2024, Journal Francais d'Ophtalmologie
    View all citing articles on Scopus
    View full text