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The Prevalence and Types of Glaucoma in Malay People: The Singapore Malay Eye Study

¹From the Singapore National Eye Centre, Singapore; the ²Singapore Eye Research Institute, Singapore; the ³Departments of Ophthalmology and ⁸Community, Occupational, and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; the ⁴Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia; the ⁵Institute of Ophthalmology, University College, London, United Kingdom; the ⁶Glaucoma Research Unit, Moorfields Eye Hospital, London, United Kingdom; and the ⁷Department of Ophthalmology, National University Hospital, Singapore.

PURPOSE. To assess the prevalence and types of glaucoma in an Asian Malay population.

METHODS. The Singapore Malay Eye Study is a population-based, cross-sectional survey that examined 3280 (78.7% response) persons aged 40 to 80 years. Participants underwent a standardized clinical examination including slit-lamp biomicroscopy, Goldmann applanation tonometry, and dilated optic disc assessment. Participants who were suspected to have glaucoma also underwent visual field examination (24-2 SITA standard, Humphrey Visual Field Analyzer II), gonioscopy, and repeat applanation tonometry. Glaucoma was defined according to International Society for Geographical and Epidemiologic Ophthalmology criteria.

RESULTS. Of the 3280 participants, 150 (4.6%) had diagnosed glaucoma, giving an age- and sex-standardized prevalence of 3.4% (95% confidence interval [CI], 3.3%–3.5%). The age- and sex-standardized prevalence of primary open-angle glaucoma was 2.5% (95% CI, 2.4%–2.6%), primary angle-closure glaucoma 0.12% (95% CI, 0.10%–0.14%), and secondary glaucoma 0.61% (95% CI, 0.59%–0.63%). Of the 150 glaucoma cases, only 12 (8%) had a previous known history of glaucoma. Twenty-seven (18%) eyes had low vision (based on best corrected visual acuity logarithm of the minimal angle of resolution [logMAR] >0.30 to <1.00 in the eye with glaucoma for unilateral cases; and based on the better eye for bilateral cases) and 15 (10%) were blind (logMAR, 1.00).

CONCLUSIONS. The prevalence of glaucoma among Malay persons 40 years of age and older in Singapore is 3.4%, comparable to ethnic Chinese people in Singapore and other racial/ethnic groups in Asia. As in Chinese, Caucasians, and African people, primary open-angle glaucoma was the main form of glaucoma in this population. More than 90% of glaucoma cases were previously undetected.

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