THE AFRICAN CARIBBEAN EYE SURVEY - RISK-FACTORS FOR GLAUCOMA IN A SAMPLE OF AFRICAN CARIBBEAN PEOPLE LIVING IN LONDON

The purpose of the study was to estimate the prevalence of and risk fa ctors for chronic glaucoma in a sample of African Caribbean people ove r 35 years of age living in the London Borough of Haringey. A cross-se ctional voluntary sample of persons were subjected to detailed ophthal mic assessment including automated tangent screen suprathreshold visua l field testing, applanation tonometry and stereoscopic disc evaluatio n in 50 community-based survey clinics over an 8 month period. Cases a nd suspects were referred to Moorfields Eye Hospital for more detailed assessment and confirmation of the diagnosis. Of 873 eligible persons examined (out of a total of 1022), 32 definite cases of glaucoma were identified, a prevalence of 3.9%; 42% of these had been previously di agnosed. Approximately 10% of the sample required further assessment a nd follow-up when ocular hypertensives and glaucoma suspects were incl uded. An age-standardised comparison with the findings of the Roscommo n survey revealed a relative risk for glaucoma for Haringey blacks com pared with Irish whites of 3.7. Significant risk factors for glaucoma included age, African birthplace and darker skin colour. Neither diabe tes nor hypertension reached significance. Despite the lack of a popul ation base, this study provides strong evidence that the 4 times great er risk of glaucoma estimated for American blacks compared with whites applies equally to the United Kingdom population. Community-based fac ilities are required to raise awareness of the risk among this ethnic minority in this country and case-finding resources should be provided to meet local needs.