Epidemiology and Clinical Spectrum of Glaucoma at a Tertiary-Care Center in Eastern Uttar Pradesh, India: a Hospital-Based Cross-Sectional Study

Abstract

Background: Glaucoma is a leading cause of irreversible blindness and remains underdiagnosed until advanced optic neuropathy occurs. In India, population-based studies report adult prevalence in the range of ~2.7–4.3%, but regional clinic-level epidemiology from Eastern Uttar Pradesh remains limited. Contemporary evidence confirms that intraocular pressure (IOP) reduction slows progression, making early detection clinically meaningful.

Methods: A hospital-based cross-sectional study was conducted in the Department of Ophthalmology at Uma Nath Singh Autonomous State Medical College, Jaunpur, from June 2025 to November 2025. Adults aged ≥40 years presenting to the ophthalmology outpatient department (OPD) with symptoms suggestive of glaucoma (watering/redness, ocular pain, headache, or frequent refractive correction changes) underwent standardized evaluation. Examination included best-corrected visual acuity (Snellen), IOP measurement by applanation tonometry, slit-lamp biomicroscopy, gonioscopy for angle assessment, and dilated fundus examination with 90D lens for optic disc evaluation. Glaucoma subtypes were classified clinically as primary open-angle glaucoma (POAG), primary angle-closure glaucoma (PACG), primary angle-closure disease (PACD), and secondary glaucoma based on history and examination. Data were analyzed in SPSS v26. Categorical variables were reported as frequencies/percentages; prevalence estimates were presented with 95% confidence intervals (CI).

Results: Among 1,470 eligible OPD attendees evaluated during the study period, 80 were diagnosed with glaucoma, yielding a clinic-based prevalence of 5.44% (95% CI 4.39%–6.72%). Glaucoma cases were predominantly male (46/80; 57.5%). Mean age among glaucoma cases was 58.0 ± 7.2 years. POAG was the most frequent subtype (36/80; 45.0%). Secondary glaucomas constituted 7/80 (8.75%), with pigmentary glaucoma the commonest secondary etiology. A history of long-term steroid use was documented in 16/80 glaucoma patients; steroid-associated glaucoma prevalence in the evaluated OPD cohort was 1.09% (16/1,470).

Conclusion: In this symptomatic tertiary-care OPD cohort from Eastern Uttar Pradesh, glaucoma burden was substantial, dominated by POAG, with increasing frequency in older age groups and a clinically relevant contribution from steroid exposure. These findings support targeted screening of high-risk patients and systematic monitoring of steroid users.