Prevalence of glaucoma in an urban West African population: the Tema Eye Survey

Donald L Budenz, Keith Barton, Julia Whiteside-de Vos, Joyce Schiffman, Jagadeesh Bandi, Winifred Nolan, Leon Herndon, Hanna Kim, Graham Hay-Smith, James M Tielsch, Tema Eye Survey Study Group

Research output: Contribution to journalArticlepeer-review

86 Citations (Scopus)


IMPORTANCE: Multiple studies have found an increased prevalence, younger age at onset, and more severe course of glaucoma in people of African descent, but these findings are based on studies conducted outside Africa.

OBJECTIVE: To determine the prevalence of glaucoma in an urban West African population of adults.

DESIGN AND SETTING: A population-based, cross-sectional study of adults 40 years and older conducted from September 1, 2006, through December 31, 2008, from 5 communities in Tema, Ghana.

PARTICIPANTS: Participants from randomly selected clusters underwent a screening examination that consisted of visual acuity, frequency doubling perimetry, applanation tonometry, and optic disc photography. Participants who failed any of these tests were referred for complete examination, including gonioscopy, standard automated perimetry, and stereoscopic optic disc photography.

RESULTS: A total of 6806 eligible participants were identified, and 5603 (82.3%) were enrolled in the study. The field examination referred 1869 participants (33.3%) to the clinic examination, and 1538 (82.2%) came for complete examination. A total of 362 participants were identified as having glaucoma of any type and category. Primary open-angle glaucoma was the underlying diagnosis in 342 participants (94.5%). The prevalence of primary open-angle glaucoma was 6.8% overall, increasing from 3.7% among those 40 to 49 years old to 14.6% among those 80 years and older, and was higher in men than in women in all age groups, with an overall male-female prevalence ratio of 1.5. Of the participants with glaucoma, 9 (2.5%) were blind using World Health Organization criteria, and only 12 (3.3%) were aware that they had glaucoma.

CONCLUSIONS AND RELEVANCE: The prevalence of glaucoma is higher in this urban West African population than in previous studies of people of East or South African and of non-African descent. Strategies to identify affected persons and effectively manage the burden of glaucoma are needed in West Africa.

Original languageEnglish
Pages (from-to)651-8
Number of pages8
JournalJAMA Ophthalmology
Issue number5
Early online date28 Mar 2013
Publication statusPublished - May 2013
Externally publishedYes


  • Adult
  • African Continental Ancestry Group
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Ghana
  • Glaucoma, Open-Angle
  • Gonioscopy
  • Health Surveys
  • Humans
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Prevalence
  • Sex Distribution
  • Tonometry, Ocular
  • Urban Population
  • Visual Acuity
  • Visual Field Tests
  • Visual Fields
  • Journal Article
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't


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