Recent figures have unveiled a sobering reality: over a million individuals in the UK are grappling with glaucoma, a principal cause of blindness. The extent of this condition is far more significant than previously estimated, and experts caution that the numbers could swell in the upcoming decades as the population continues to age.

The Institute of Ophthalmology’s analysis forecasts that by 2060, the number of people over 40 afflicted by this debilitating eye disease could surpass 1.6 million. This projection has sparked urgent calls for more frequent eye examinations among middle-aged and older adults to mitigate the impact of the disease.

Glaucoma occurs when pressure inside the eye increases, damaging the optic nerve responsible for transmitting visual information to the brain. While it predominantly affects individuals aged 50 and above, the disease is notorious for its lack of symptoms until it reaches advanced stages, at which point vision loss is irreversible.

Researchers involved in the study emphasized the critical need for specific public health strategies, noting that over 40 percent of glaucoma patients in the UK suffer from avoidable vision impairment due to late diagnosis. These findings highlight the importance of early detection through regular eye checks to prevent needless sight loss.

It is most common in people aged 50 and over, but often causes no symptoms until its later stages, when sight loss is already permanent.

Eye experts involved in the research said the findings ‘underscore the need for targeted public health strategies’, warning that more than 40 per cent of patients in the UK suffer preventable vision loss because their condition is diagnosed too late.

Using official population data, researchers estimated that 1,019,629 adults aged 40 and over are currently living with glaucoma in the UK. 

However, they cautioned the real figure could be far higher, with more than half of cases believed to be going undiagnosed.

Glaucoma is usually caused by a build-up of pressure in the eye which occurs when fluid cannot drain properly

This increase in pressure damages the optic nerve, which connects the eye to the brain 

Writing in the British Journal of Ophthalmology, the team said previous estimates – which suggested around 700,000 people in the UK had glaucoma – failed to reflect the country’s changing population.

The risk of glaucoma rises sharply with age, with around 11 per cent of people aged 85 and over predicted to have the condition.

But experts warned the expected surge will be driven not only by an ageing population, but also by growth in higher-risk ethnic groups.

Dr Laura Antonia Meliante, from the Institute of Ophthalmology and the study’s lead author, said: ‘These demographic shifts are anticipated to amplify the burden of glaucoma on the healthcare system over the forthcoming decades, underscoring the need for long-term healthcare planning to address growing demand.

‘Accurate, up-to-date estimates and long-term projections are therefore essential for the development and implementation of viable preventative strategies, including public awareness campaigns aimed at reducing delays in diagnosis and treatment.’

In a commentary accompanying the research, eye specialists Dr Alexander Schuster and Dr Cedric Schweitzer said the findings exposed an urgent gap in prevention.

‘This increase underlines a critical need for strategies that go beyond treatment options, focusing on evidence-based healthcare planning, including structured case detection and treatment to prevent blindness at old age,’ they said.

‘It is now time to take action by scientifically developing and evaluating these strategies.’ 

It’s not always known why glaucoma occurs, but a person’s risk is higher if they are over 50, have a brother, sister or parent with the condition or have other medical conditions such as diabetes 

To produce the estimates, researchers analysed data from the most recent census in 2021–22, focusing on adults aged 40 and over, as glaucoma is rare in younger people.

While the exact cause is not always known, a person’s risk is higher if they are over 50, have a close family member with the condition, or have other medical problems such as diabetes.

Participants were grouped by age, sex and broad ethnic background. In total, 34 million people were included, the majority living in England and Wales.

Women made up just over half of the group, and most participants were of European ancestry. Rates of glaucoma were slightly higher in men, with African ethnic groups showing the highest prevalence and Asian populations the lowest.

Among people of European ancestry, the greatest number of cases was seen in the oldest age group – largely reflecting the fact that nearly 40 per cent were aged 65 or over.

Based on these trends, the researchers projected a 60 per cent rise in glaucoma cases by 2060. Less than half of that increase will be driven by people under 40, with ethnically diverse communities and those aged over 75 hit hardest.

Calling for routine eye checks to be strengthened, the researchers warned: ‘Approximately half of glaucoma cases remain undiagnosed even in well-resourced healthcare systems.

‘This gap is even greater among ethnic minority groups, who are more likely to experience delays in diagnosis and to present with advanced disease.’ 

If glaucoma is diagnosed and treated early, it may not result in vision loss 

They said this was particularly worrying given that up to 16 per cent of patients go on to develop blindness in both eyes by the end of their lives.

‘Lifetime visual prognosis remains a major concern for patients,’ the team concluded, ‘underscoring the importance of accurately identifying those at highest risk of progression to sight loss, alongside implementing effective long-term management strategies.’

Dr Schuster and Dr Schweitzer also pointed to evidence from a recent Swedish trial showing that population-wide screening at age 67 could halve the number of people who lose their sight to glaucoma.

While glaucoma usually develops silently, it can sometimes strike suddenly, causing intense eye pain, redness, blurred vision, headache, nausea and vomiting. The NHS warns that similar symptoms can also be caused by injury or inflammation.

Most cases are picked up during routine eye tests, often before symptoms appear. For this reason, the NHS advises adults to have their eyes checked at least every two years – with more frequent tests recommended for those at higher risk.

There is no cure for glaucoma, but treatments such as eye drops, laser therapy and surgery can slow the disease and prevent further sight loss if started early.

Sight loss is estimated to cost the UK £58 billion a year through lost productivity and pressure on the NHS and social care services, with vision impairment also linked to a higher risk of dementia.