African Americans and Glaucoma

After cataracts, glaucoma is the leading cause of blindness in African Americans. Half of those with glaucoma don't know they have it.

After cataracts, glaucoma is the leading cause of blindness in African Americans. Many people are unaware that:

  • Glaucoma strikes earlier and progresses faster in African Americans.
  • The risk for glaucoma is 20% higher if glaucoma is in your family.

African Americans belonging to any of these risk groups have an even greater risk of developing glaucoma:

  • Over age 40
  • Extreme nearsightedness
  • Diabetes
  • Hypertension
  • Prolonged steroid use

Glaucoma occurs about five times more often in African Americans. Blindness from glaucoma is about six times more common. In addition to this higher frequency, glaucoma often occurs earlier in life in African Americans — on average, about 10 years earlier than in other ethnic populations.

African Americans should get a thorough check for glaucoma every one to two years after age 35.

Why is there a difference?

The reasons for the higher rate of glaucoma and subsequent blindness among African Americans are still unknown. However, research shows that African Americans are genetically more at risk for glaucoma, making early detection and treatment all the more important.

In studies such as the Baltimore Eye Survey and the Barbados Eye Study, researchers have investigated how glaucoma affects different black populations. Information from these and other studies will help us better understand the risk factors for African Americans, and eventually, in developing more effective treatments.

Does glaucoma treatment differ?

Although treatment varies for all individuals, the overall goal is to prevent further damage and sight loss from glaucoma. One way that eye doctors seek to meet this goal is to aim for a target eye pressure.

In African Americans, glaucoma generally occurs earlier, often with a greater rate of vision loss. Because of this, an eye doctor may work with a patient to target an eye pressure that may be lower than for other glaucoma patients.

It is important to note, however, that treatments cannot be generalized. Each patient, regardless of race, should continue to be evaluated on the individual state of his or her disease, with a target pressure and treatment plan unique to each patient.

Although much still needs to be learned about why African Americans are more at risk for glaucoma, one thing is certain. Early diagnosis and treatment is key in preventing vision loss from glaucoma.

Glaucoma Runs in Families

Research has shown that siblings of persons diagnosed with glaucoma have nearly a 10-fold increased risk of having glaucoma when compared to siblings of persons without glaucoma.

This means that a 65 year old sibling of a European-derived person has about a 10% chance of having glaucoma, while a 65 year old sibling of an African American has nearly a 20% chance of having glaucoma.

Clearly brothers and sisters of patients with glaucoma can benefit from regular eye examinations with special attention to careful screening for glaucoma.


Article by Joanne Katz, ScD, MS, BSc, and David S. Friedman, MD, PhD, MPH.
Last reviewed on March 21, 2023.

Joanne Katz is an epidemiologist, biostatistician, and professor at Johns Hopkins Bloomberg School of Public Health.