Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec;106(12):1684-1688.
doi: 10.1136/bjophthalmol-2020-317718. Epub 2021 Jun 25.

Risk factors for previously undiagnosed primary open-angle glaucoma: the EPIC-Norfolk Eye Study

Michelle P Y Chan  1 , Anthony P Khawaja  2   3 , David C Broadway  4 , Jennifer Yip  5 , Robert Luben  6 , Shabina Hayat  6 , Tunde Peto  7 , Kay-Tee Khaw  6 , Paul J Foster  2
Affiliations

Risk factors for previously undiagnosed primary open-angle glaucoma: the EPIC-Norfolk Eye Study

Michelle P Y Chan et al. Br J Ophthalmol. 2022 Dec.

Abstract

Background and aim: Undiagnosed glaucoma is an invisible but important public health issue. At least half of glaucoma cases are estimated to be undiagnosed in western populations. The aim of this study is to examine risk factors for previously undiagnosed primary open-angle glaucoma (POAG).

Design: Cross-sectional study within the European Prospective Investigation of Cancer-Norfolk Eye Study, a large-scale cohort study in the UK.

Participants: 314 study participants with POAG in either eye.

Methods: Logistic regression was used to examine associations with previously undiagnosed POAG compared with previously diagnosed POAG. The factors examined included sociodemographic, ocular, physical and economic factors that could be barriers to eye care access.

Results: 217 participants had previously diagnosed POAG and 107 participants were newly diagnosed with POAG during the study. After adjusting for covariables, the factors significantly associated with previously undiagnosed POAG were: a lower pretreatment intraocular pressure (IOP) (OR 0.71/mm Hg, 95% CI 0.63 to 0.80, p<0.0001), and to have reported no problems with their eyesight (OR 0.03, 95% CI 0.01 to 0.10, p<0.0001).

Conclusions: The risk factors for previously undiagnosed POAG identified in this study highlight the over-reliance on IOP level in glaucoma screening and the risk of missing glaucoma among lower IOP cases. It also suggests a role in improving glaucoma awareness in the community.

Keywords: epidemiology; glaucoma.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Similar articles

See all similar articles

Cited by

References

    1. Dielemans I, Vingerling JR, Wolfs RC, et al. . The prevalence of primary open-angle glaucoma in a population-based study in the Netherlands. The Rotterdam study. Ophthalmology 1994;101:1851–5. 10.1016/S0161-6420(94)31090-6 - DOI - PubMed
    1. Mitchell P, Smith W, Attebo K, et al. . Prevalence of open-angle glaucoma in Australia. the blue Mountains eye study. Ophthalmology 1996;103:1661–9. 10.1016/s0161-6420(96)30449-1 - DOI - PubMed
    1. Hennis A, Wu S-Y, Nemesure B, et al. . Awareness of incident open-angle glaucoma in a population study: the Barbados eye studies. Ophthalmology 2007;114:1816–21. 10.1016/j.ophtha.2007.06.013 - DOI - PubMed
    1. Topouzis F, Coleman AL, Harris A, et al. . Factors associated with undiagnosed open-angle glaucoma: the Thessaloniki eye study. Am J Ophthalmol 2008;145:327–35. 10.1016/j.ajo.2007.09.013 - DOI - PubMed
    1. Wong EYH, Keeffe JE, Rait JL, et al. . Detection of undiagnosed glaucoma by eye health professionals. Ophthalmology 2004;111:1508–14. 10.1016/j.ophtha.2004.01.029 - DOI - PubMed

Publication types