A review of factors contributing to severe progression of primary open angle glaucoma (POAG) in people of African descent

Abstract Glaucoma is the second-highest cause of blindness and the leading cause of irreversible blindness worldwide. Most people with glaucoma are not aware that they have a sight-threatening condition. People of African ancestry/descent have been noted over time to have more severe disease, with rapid progression to blindness, compared to those of other races. There’s been growing interest in understanding how glaucoma affects people of African descent, particularly in terms of its progression and impact on vision. Research has highlighted the need for targeted approaches to diagnosis, treatment, and management of the condition in this population. This article aims to review documented evidence that suggests a more severe course and rapid progression of glaucoma among people of African descent, highlighting possible contributory factors. Epidemiologic risk factors, functional and structural variations A PubMed and Google Scholar search was conducted using the following keywords: glaucoma, progression, risk factors, severity, Africans, blacks. From the different studies considered in this narrative review, there is substantial evidence to believe that people of African descent usually have lower Central corneal thickness, higher intraocular pressure, and earlier and severe presentation of POAG compared to other racial groups. This is even worse for those living in sub-Saharan Africa due to inequalities that affect access to health care and compliance with treatment. Additionally, the unique genetic factors have been linked to these conditions. However, most of them are still being investigated. In conclusion, glaucoma remains a major challenge to many black populations. This review has suggested a link between genetic, psychosocial, and environmental factors in the severity and progression of the disease among blacks, especially among the underserved and vulnerable groups in sub-Saharan Africa. There is a need for continuous health education and sustained advocacy with governments and development partners to improve access. Finally, the need for more research funding for a better understanding of more gray areas relating to the mechanism of glaucoma in ‘black’ populations is paramount.