The Barbados Eye Study

TLDR

The Barbados Eye Study aimed to describe its design and report the prevalence of open-angle glaucoma in a predominantly black population. The study recruited a simple random sample of Barbadian-born citizens aged 40–84, performed comprehensive visits including automated perimetry, applanation tonometry, and fundus photography, referred participants with specific findings and a 10% random sample for ophthalmologic examination, and diagnosed OAG using both visual field and optic disc criteria after excluding other causes. In this population-based study of 4,631 Barbadian adults, the prevalence of open-angle glaucoma was 7.0% among black participants, 3.3% among mixed-race, and 0.8% among white/other, rising to 12% in those aged 60 and older and higher in men, with one in 11 over 50 and one in six over 70, making it the largest glaucoma study in a black population and underscoring its public health significance.

Abstract

To describe the design of the Barbados Eye Study and report on the prevalence of open angle glaucoma (OAG) in a predominantly black study population.Population-based prevalence study.Residents of Barbados, West Indies, identified from a simple random sample of Barbadian-born citizens 40 through 84 years old.Participants had a comprehensive study visit that included automated perimetry, applanation tonometry, and fundus photography; persons with specific examination findings, as well as a 10% sample of participants, were referred for an ophthalmologic examination and additional tests.A diagnosis of OAG required both visual field and optic disc criteria for glaucoma damage after excluding other causes.The 4709 participants (83.5% of those eligible) had demographic characteristics that were similar to the census population. Of the 4631 participants who were tested at the study site, 95% completed Humphrey automated perimetry and 97% had photographic or clinical disc gradings; 93% of those referred completed the ophthalmologic examination. In this adult population, the prevalence of OAG by self-reported race was 7.0% (302/4314) in black, 3.3% (6/184) in mixed-race, and 0.8% (1/133) in white or other participants. In black and mixed-race participants, the prevalence reached 12% at age 60 years and older and was higher in men (8.3%) than in women (5.7%), with an age-adjusted male-female ratio of 1.4. In addition, over 3% of the participants were classified as having suspect OAG.To our knowledge, the Barbados Eye Study is the largest glaucoma study ever conducted in a black population and identified more people with OAG than did any previous population study. The prevalence of OAG was high, especially 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 years or older. The results highlight the public health importance of OAG in the Afro-Caribbean region and have implications for other populations.