Prevalence of Glaucoma in India over 2 Decades and Projections to 2050: A Systematic Review and Meta-Analysis.

Abstract

<h4>Topic</h4>This study synthesizes data on prevalence of glaucoma in India for the year 2020 and projects the disease burden through 2050.<h4>Clinical relevance</h4>Robust, country-specific prevalence estimates are essential to inform public health policy, guide resource allocation, and support advocacy for glaucoma prevention and care in India.<h4>Methods</h4>We included population-based studies published between January 2000 and January 2024 reporting glaucoma prevalence among individuals aged ≥40 years in India. A systematic search was conducted in PubMed, Scopus, and Web of Science using keywords and MeSH terms related to glaucoma epidemiology. Two independent reviewers (N.B. and T.S.) screened articles using predefined criteria and extracted data. Risk of bias was assessed using the Joanna Briggs Institute's checklist. Pooled prevalence estimates were calculated using a random-effects restricted maximum likelihood model. A linear regression model projected future prevalence of glaucoma. Subgroup, meta-regression, and sensitivity analyses explored sources of heterogeneity (I²), and publication bias was assessed using Egger test.<h4>Results</h4>Out of 1657 identified articles, 13 studies with a cumulative sample of 50 671 participants were included in the meta-analysis. Study sample sizes ranged from 680 to 7438 participants. All included studies showed low risk of bias. The pooled glaucoma prevalence in India was estimated at 3.23% (95% confidence interval: 2.54-3.92; I² = 95.52), with subtype-specific prevalence of 2.07% for primary open-angle glaucoma (POAG), 0.81% for primary angle-closure glaucoma (PACG), and 0.29% for both secondary glaucoma and pseudoexfoliation glaucoma. Subgroup analyses revealed significant variation in prevalence by age, gender, geographic zone, habitation, and diagnostic criteria, ranging from 0.29% to 4.92%. Despite stratification, heterogeneity remained high (I² = 50.57-97.62). By 2050, overall glaucoma prevalence is projected to increase to 4.52% (a 28.77% rise), with PACG prevalence doubling and POAG rising by 18.26%. No publication bias was detected (Egger test, P = 0.2431).<h4>Conclusion</h4>Glaucoma poses a substantial public health challenge in India, with marked demographic and regional disparities. Strengthening prevention strategies, enhancing early detection, and addressing epidemiological data gaps are vital to mitigate the growing disease burden and inform public health responses.<h4>Financial disclosures</h4>The authors have no proprietary or commercial interest in any materials discussed in this article.