Glaucoma and Ethnicity: Who Is Most at Risk?

Glaucoma does not affect all populations equally. While anyone can develop the condition, research consistently shows that certain ethnic groups face significantly higher risk. Understanding these differences is not about creating alarm but about empowering communities with the knowledge they need to take proactive steps toward protecting their vision.

People of African descent

Among all ethnic groups studied, people of African descent face the highest risk of primary open-angle glaucoma (POAG), the most common form of the disease. Research indicates that this population is three to four times more likely to develop POAG compared to people of European descent.

The differences go beyond prevalence. In people of African descent, glaucoma tends to develop at an earlier age, often appearing in the 40s rather than the 50s or 60s. The disease also tends to progress more rapidly and can be more resistant to treatment. These factors combined mean that early awareness and regular eye examinations are particularly important for this group.

Studies have also found that people of African descent are more likely to have thinner central corneas, which can cause standard eye pressure measurements to underestimate the true intraocular pressure. This anatomical difference can contribute to delayed identification of the condition.

East Asian populations

While POAG is the most common form of glaucoma globally, East Asian populations face elevated risk for two specific subtypes: normal-tension glaucoma and angle-closure glaucoma.

Normal-tension glaucoma occurs when optic nerve damage develops even though intraocular pressure remains within the statistically normal range. This form is disproportionately common in people of Japanese, Korean and Chinese descent. Because standard pressure checks may return normal readings, normal-tension glaucoma can be particularly easy to miss without a thorough optic nerve and visual field assessment.

Angle-closure glaucoma, which occurs when the drainage angle of the eye becomes physically blocked, is also more prevalent in East Asian populations. This is partly due to anatomical factors, as people of East Asian descent are more likely to have shallower anterior chambers and shorter axial eye lengths, both of which predispose to angle closure. While acute angle-closure attacks are dramatic and painful, chronic angle closure can develop gradually and silently, similar to open-angle glaucoma.

Hispanic and Latino populations

Research shows that Hispanic and Latino populations, particularly those over the age of 65, face glaucoma risk levels comparable to those seen in people of African descent. The Proyecto VER and Los Angeles Latino Eye Study (LALES) both found significantly elevated rates of open-angle glaucoma in older Hispanic adults compared to age-matched populations of European descent.

As with other at-risk groups, lower rates of routine eye care utilisation in some Hispanic communities can compound the problem. Language barriers, limited access to healthcare and lack of awareness about the condition all contribute to later identification and more advanced disease at the time of diagnosis.

Indigenous Australians

In the Australian context, Indigenous Australians experience higher rates of eye disease overall, including glaucoma. The National Eye Health Survey found that Indigenous Australians are significantly more likely to have vision impairment and blindness compared to non-Indigenous Australians.

Access to eye care is a major factor. Many Indigenous communities are located in regional and remote areas where optometry and ophthalmology services are limited or require significant travel. Even in urban settings, systemic barriers to healthcare access can result in less frequent eye examinations and later presentation.

Closing this gap requires culturally appropriate outreach, community-based awareness programmes and removing practical barriers to accessing eye care services.

Why these disparities exist

The reasons behind ethnic differences in glaucoma risk are complex and multifactorial:

• Genetics. Variations in genes related to intraocular pressure regulation, optic nerve susceptibility and aqueous humour drainage contribute to differing baseline risk levels across populations.
• Ocular anatomy. Differences in corneal thickness, anterior chamber depth and optic disc size vary across ethnic groups and influence both disease susceptibility and the accuracy of standard clinical measurements.
• Access to care. Socioeconomic factors, geographic location, language barriers and cultural attitudes toward healthcare all affect how often people receive eye examinations, which in turn affects how early glaucoma is identified.
• Awareness gaps. In many communities, there is limited public knowledge about glaucoma as a condition, let alone understanding of ethnicity-specific risk factors. Without this awareness, people have little reason to prioritise eye exams.

What this means for awareness

Understanding ethnicity-based risk factors is not about assigning blame or causing anxiety. It is about ensuring that the people most at risk have the information they need to act. If you belong to a higher-risk group, the single most important thing you can do is schedule regular comprehensive eye examinations with a qualified optometrist or ophthalmologist.

Educational awareness tools like G-Screen can help individuals learn about their risk factors and understand why professional eye care matters. You can also explore our glaucoma risk factors page for a broader overview of all the factors that influence glaucoma risk, including age, family history and medical conditions.

Awareness is the first step. Action is what protects vision.