Global mortality of glaucoma: a systematic review and meta-analysis of prospective studies.

OBJECTIVES

To quantify the mortality and relative mortality risk of glaucoma and its subtypes through a systematic review and meta-analysis.

METHODS

We identified prospective studies reporting glaucoma mortality published from January 1, 1990 to August 9, 2025. Data on absolute mortality and relative mortality risk of primary open-angle glaucoma (POAG), primary angle-closure glaucoma (PACG), and congenital glaucoma were extracted. The absolute mortality was reported either as cumulative mortality or mortality rate, and the relative mortality risk was reported as hazard ratio (HR), risk ratio (RR), or odds ratio (OR). The annual cumulative mortality (ACM) of POAG was transformed from cumulative mortality and pooled using a random-effects meta-analysis. Unadjusted and fully adjusted HRs of mortality risk comparing people with and without POAG were also pooled using random-effects meta-analyses.

RESULTS

Seven articles were included. The pooled ACM of POAG was 3.42% (95% confidence interval [CI] 1.70%-5.58%). The mortality rate of POAG was reported in one study as 6.1 (95% CI 5.5-6.7) per 1000 person-years. A significant association between POAG and mortality was observed in the pooled unadjusted relative mortality risk estimates (HR 2.14, 95% CI 1.32-3.47). Fully adjusted relative mortality risk estimates did not show a significant association with mortality (HR 1.13, 95% CI 0.91-1.40). The cumulative mortality of PACG over ten years (47.6%, 95% CI 25.7%-70.2%) and the cumulative mortality of congenital glaucoma over 15 years (3.48%) were reported.

CONCLUSION

In the context of global aging, integrating glaucoma care with comprehensive management of systemic health may help improve long-term outcomes among individuals with glaucoma. More prospective studies are needed to provide a basis for allocating resources for eye health care.