THE BARBADOS EYE STUDY - PREVALENCE OF OPEN-ANGLE GLAUCOMA

Objective: To describe the design of the Barbados Eye Study and report on the prevalence of open angle glaucoma (GAG) in a predominantly bla ck study population. Design: Population-based prevalence study. Settin g and Participants: Residents of Barbados, West Indies, identified fro m a simple random sample of Barbadian-born citizens 40 through 84 year s old. Data Collection: Participants had a comprehensive study visit t hat included automated perimetry, applanation tonometry, and fundus ph otography; persons with specific examination findings, as well as a 10 % sample of participants, were referred for an ophthalmologic examinat ion and additional tests. Outcome: A diagnosis of OAG required both vi sual field and optic disc criteria for glaucoma damage after excluding other causes. Results: The 4709 participants (83.5% of those eligible ) had demographic characteristics that were similar to the census popu lation. Of the 4631 participants who were tested at the study site, 95 % completed Humphrey automated perimetry and 97% had photographic or c linical disc gradings; 93% of those referred completed the ophthalmolo gic examination. In this adult population, the prevalence of OAG by se lf-reported race was 7.0% (302/4314) in black, 3.3% (6/184) in mixed-r ace, and 0.8% (1/133) in white or other participants. In black and mix ed-race participants, the prevalence reached 12% at age 60 years and o lder and was higher in men (8.3%) than in women (5.7%), with an age-ad justed male-female ratio of 1.4. In addition, over 3% of the participa nts were classified as having suspect OAG. Conclusions: To our knowled ge, the Barbados Eye Study is the largest glaucoma study ever conducte d in a black population and identified more people with OAG than did a ny previous population study. The prevalence of OAG was high, especial ly at older ages and in men. Among participants 50 years old or older, one in 11 had OAG, and prevalence increased to one in six at age 70 y ears or older. The results highlight the public health importance of O AG in the Afro-Caribbean region and have implications for other popula tions.