The prevalence of visual disability among screened populations may vary between 0.03% and 2.4% while some registry-based retrospective studies have reported clearly higher prevalence rates compared to cross-sectional screening studies (visual disability in both eyes in 15% within 15 years and 22% in 20 years, visual disability in one eye in 9% in 10 years and 54% in 20 years). The Finnish study reported that 1.5% of patients using glaucoma medications were registered in the Registry of Visual Disability (Vaajanen et al 2021). As not all patients using glaucoma medications have glaucomatous abnormalities, the percentage can be higher.
The 1980-2019 data of the Finnish Register of Visual Impairment were reported. The criteria for vision loss were based the World Health Organization definitions (mild, moderate, severe, near total blindness and blindness). By the end of 2019, the registry included data on 58 822 visually impaired patients. 5819 patients had glaucoma as the main diagnosis (61 % females). The data of reimbursed glaucoma medications were available in 1986-2019 by the Finnish Social Insurance Institution.
Primary open-angle glaucoma was the main diagnosis in 45% of cases, followed by exfoliative glaucoma (30%) and normal-tension glaucoma (7 %). The incidence of visual disability per 100 000 citizens increased from 2.3 to 3.4 during four decades (p=0.0026) and was related to the increase in the ≥ 85 -year age group, especially in females.
The mean age of males was 74 years and 76 years in females and increased 4 years in males and 7 years in females in 1980-2019. The years with disability decreased from 10 to 7 years in females and from 10 to 9 years in males.
The percentage of mild vision loss increased from 40% to 51% during the 40 years (p < 0.0001) with no differences between gender. The incidence of vision impairment per 10 000 treated glaucoma patients decreased from 32 to 21 during the four decades (p < 0.0001).
Authors' conclusions:
During 4 decades, the incidence of glaucoma induced visual disability increased due to a shift into to older age groups and higher percentage of mild vision loss which may reflect to improved glaucoma care.
Screening studies R1-R8,Retrospective and registry base studies R9-R19