Purchase this article with an account.
Jacqueline Chua, Baskaran Mani, Jiemin Liao, Yingfeng Zheng, Tien Y Wong, Tin Aung, Ching-Yu Cheng, Singapore Epidemiology of Eye Disease (SEED) Study; Determinants of Undetected Glaucoma in an Asian Community: The Singapore Epidemiology of Eye Disease (SEED) Study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4274.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To examine factors influencing undetected glaucoma across three major ethnic groups - Chinese, Malays and Indians - in Singapore.
The Singapore Epidemiology of Eye Disease (SEED) Study examined a total of 10,033 persons (75.7% response rate), comprising 3,353 Chinese, 3,280 Malays and 3,400 Indians aged 40-80 years. An age-stratified random sample of people residing in south-western Singapore was selected from a national database. Subjects were invited for a structured interview and a standardized comprehensive eye examination, including visual field assessment, based on the same study protocol. Subjects with previously undiagnosed glaucoma (i.e., not answering "yes" to previously being told by a doctor of having glaucoma) were identified after the eye examination.
A total of 361 subjects were diagnosed as having glaucoma. Of them, 286 (79.2%) were unaware of having glaucoma. In the multiple regression analysis, subjects who were unaware of having glaucoma were younger (odds ratio [OR], 1.32, per 5 year, p=0.001) and more likely to be Malay (OR 4.38, p<0.001); had lower education levels (OR 2.08, p=0.036) and less regular eye checks (OR 4.48, p<0.001), were less likely to wear glasses (OR 2.87, p=0.014), and less likely to have undergone cataract surgery (OR 4.10, p<0.001), compared to those who were aware of their condition.
Our study provides population-based data in an Asian community showing that among persons with glaucoma, a large proportion is undetected. Factors associated with undetected glaucoma were younger age, Malay ethnicity, lower education, and under-utilization of eye care resources. This has implications for public health activities to improve glaucoma awareness in these high-risk groups. Tailored ophthalmic services at primary health care level targeted to high risk groups may be warranted.
This PDF is available to Subscribers Only