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 Table of Contents  
Year : 2021  |  Volume : 33  |  Issue : 3  |  Page : 386-387

Prevalence and risk factors for primary glaucoma in Kerala – The need for information

1 Department of Ophthalmology, GMC, Kannur, Kerala, India
2 Department of Ophthalmology, GMC, Thrissur, Kerala, India
3 Department of Ophthalmology, MOSC Medical College, Kolenchery, Kerala, India
4 Department of Ophthalmology, GMC, Idukki, Kerala, India
5 Department of Ophthalmology, RIO, Thiruvananthapuram, Kerala, India
6 Department of Ophthalmology, GMC, Alappuzha, Kerala, India

Date of Submission03-Jun-2021
Date of Acceptance07-Jun-2021
Date of Web Publication08-Dec-2021

Correspondence Address:
A V Asha
Professor of Ophthalmology, GMC, Kannur, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/kjo.kjo_132_21

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How to cite this article:
Asha A V, Laly T U, Menon L, Greeshma M G, Sadasivan K S, Arya A R, Raveendran R, Naveena. Prevalence and risk factors for primary glaucoma in Kerala – The need for information. Kerala J Ophthalmol 2021;33:386-7

How to cite this URL:
Asha A V, Laly T U, Menon L, Greeshma M G, Sadasivan K S, Arya A R, Raveendran R, Naveena. Prevalence and risk factors for primary glaucoma in Kerala – The need for information. Kerala J Ophthalmol [serial online] 2021 [cited 2022 Jan 19];33:386-7. Available from: http://www.kjophthal.com/text.asp?2021/33/3/386/331917

Dear Sir,

We wish to highlight the lack of population or hospital-based information on the prevalence and risk factors for glaucoma from Kerala. Glaucoma is reported in an estimated 11.2 million persons aged 40 years or older in India.[1] Primary open-angle glaucoma (POAG) is more common with an estimated 6.48 million persons and primary angle-closure glaucoma (PACG) is reported in an estimated 2.54 million persons.[1] An estimated 27.6 million persons may have any form of primary angle-closure disease.[1] Population-based studies from South India have reported varying prevalence rates for glaucoma that vary from 0.4% to 4% for POAG and 0.5% for angle-closure glaucoma with a reported urban rural difference in the prevalence.[2],[3],[4],[5],[6] Increasing age and increased intraocular pressures are reported as risk factors for POAG, and increased age, female gender, short axial length, thicker cornea with steep corneal curvature, and thicker lens with anterior lens position were found to be significant risk factors for PACG.[2],[7],[8]

Glaucoma can lead to irreversible blindness and an estimated 1.5 million people are blind from glaucoma in India. It is estimated that over 75% of the people with glaucoma are undiagnosed in low- and middle-income countries including India.[9] Knowledge of the estimates of the magnitude, risk factors, consequences of glaucoma, and prevalence of undiagnosed glaucoma are important to develop appropriate screening and diagnostic strategies. Population-based estimates from the other South Indian states may be considered as a surrogate for the magnitude of glaucoma in Kerala but may be unreliable when we consider the large variation in the prevalence measures among those studies. In addition, all the major prevalence studies on glaucoma from Southern India are more than a decade old and we cannot be sure if those estimates are applicable now. Glaucoma is a disease that is more common in the elderly and the prevalence or proportion of glaucoma may have increased as the population demographics have changed toward aging in Kerala.

It is important that Kerala has a state-level strategy to address this important cause of irreversible blindness. These must include standardized strategies for screening, diagnosis, and strategies to improve the reach and outcomes of therapeutic interventions. Accurate baseline estimates of the prevalence and incidence, risk factors, and prognostic factors for glaucoma are essential to understand the effectiveness of interventions at a population level.

The Kerala Society of Ophthalmic Surgeons must consider the feasibility of multicentric studies across several regions and diverse health care settings of Kerala to address the lack of information on glaucoma from Kerala.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

George R, Ve RS, Vijaya L. Glaucoma in India: Estimated burden of disease. J Glaucoma 2010;19:391-7.  Back to cited text no. 1
Jacob A, Thomas R, Koshi SP, Braganza A, Muliyil J. Prevalence of primary glaucoma in an Urban South Indian population. Indian J Ophthalmol 1998;46:81-6.  Back to cited text no. 2
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Garudadri C, Senthil S, Khanna RC, Sannapaneni K, Rao HB. Prevalence and risk factors for primary glaucomas in adult urban and rural populations in the Andhra Pradesh Eye Disease Study. Ophthalmology 2010;117:1352-9.  Back to cited text no. 3
Ramakrishnan R, Nirmalan PK, Krishnadas R, Thulasiraj RD, Tielsch JM, Katz J, et al. Glaucoma in a rural population of southern India: The Aravind comprehensive eye survey. Ophthalmology 2003;110:1484-90.  Back to cited text no. 4
Vijaya L, George R, Paul PG, Baskaran M, Arvind H, Raju P, et al. Prevalence of open-angle glaucoma in a rural south Indian population. Invest Ophthalmol Vis Sci 2005;46:4461-7.  Back to cited text no. 5
Vijaya L, George R, Baskaran M, Arvind H, Raju P, Ramesh SV, et al. Prevalence of primary open-angle glaucoma in an urban south Indian population and comparison with a rural population. The Chennai Glaucoma Study. Ophthalmology 2008;115:648-54.e1.  Back to cited text no. 6
Nangia V, Jonas JB, Matin A, Bhojwani K, Sinha A, Kulkarni M, et al. Prevalence and associated factors of glaucoma in rural central India. The Central India Eye and Medical Study. PLoS One 2013;8:e76434.  Back to cited text no. 7
Krishnankutty SV, Sathis G, Madhavan PK, Narayani V. A comparative analysisof ocular biometry in acute and chronic presentations of primary angle closure glaucoma. Kerala J Ophthalmol 2019;31:212-6.  Back to cited text no. 8
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Senjam SS. Glaucoma blindness-A rapidly emerging non-communicable ocular disease in India: Addressing the issue with advocacy. J Family Med Prim Care 2020;9:2200-6.  Back to cited text no. 9
  [Full text]  


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