The Changing Face of Primary Open-Angle Glaucoma in the United States: Demographic and Geographic Changes From 2011 to 2050

PURPOSE: To examine how demographic and geographic variations in US populations from 2011 to 2050 will contribute to estimated numbers of primary open-angle glaucoma (POAG) cases. DESIGN: Cross-sectional study. METHODS: Prevalence rates from selected population-based studies were used to estimate the number of persons aged 40 years and older with POAG in the United States. For calculation, the age-, sex-, and race/ethnicity-specific prevalence rates were multiplied by the US Census estimates and projections from 2011 to 2050. Main outcome measures are estimated numbers of persons with POAG in different age, sex, and racial/ethnic groups and total and per capita POAG rates by state. RESULTS: In 2011, 2.71 million persons in the United States have POAG, with the highest estimated number among populations aged 70 to 79 years (31%), women (53%), and non-Hispanic whites (44%). The largest demographic group is non-Hispanic white women. In 2050, an estimated 7.32 million persons will have POAG, with the highest number among populations aged 70 to 79 years (32%), women (50%), and Hispanics (50%). The largest demographic group will shift to Hispanic men. During the next 40 years, the highest per capita POAG rates will double in New Mexico, Texas, and Florida. CONCLUSIONS: Despite the high prevalence of POAG in African Americans and Hispanics, the largest group in the United States is currently among older non-Hispanic white women but is expected to shift to Hispanic men over the next few decades. Given this shift, the greatest yield from screening programs is likely to be in those states with high numbers of non-Hispanic white women and Hispanic men. (Am J Ophthalmol 2012;154: 303-314. (c) 2012 by Elsevier Inc. All rights reserved.)