Abstract
BACKGROUND AND AIMS: Glaucoma is a leading cause of irreversible blindness worldwide, with a disproportionate burden in Sub‑Saharan Africa. Identifying sociodemographic and clinical determinants is critical for early detection and prevention. This study identified glaucoma risk factors in Ghanaians and evaluated their prognostic significance. METHODS: A prospective hospital-based case-control study conducted at a tertiary hospital in Ghana from 1st October to 31st December, 2021, including 150 glaucoma patients and 150 age- and sex-matched controls. Sociodemographic and clinical data were collected. Predictive risk factors were assessed via multivariate logistic regression in SPSS version 25. Statistical significance was set at p < 0.05. RESULTS: Three hundred participants were recruited, including 178 (59%) females. Mean ages of glaucoma patients and controls were 58.4 ± 17.4 and 52.35 ± 18.5 years, respectively. Primary open-angle glaucoma (POAG) was the predominant type (77.3%). Statistically significant risk factors for glaucoma were: age ≥ 40 years [OR: 3.5, 95% CI: 1.8-6.7, p = 0.001], positive family history [OR: 3.2, 95% CI: 1.7-5.9, p = 0.001], hypertension [OR: 2.7, 95% CI: 1.5-5.0, p = 0.002], myopia [OR: 4.3, 95% CI: 2.1-9.1, p = 0.001], and intraocular pressure (IOP) ≥ 22 mmHg [OR: 4.1, 95% CI: 1.9-8.9, p = 0.001]. Advanced glaucoma at presentation was significantly associated with IOP ≥ 22 mmHg (p = 0.002), myopia (p = 0.001), and hypertension (p = 0.001). POAG was significantly associated with age ≥ 40 years (p = 0.001), family history of glaucoma (p = 0.001), and education (p = 0.031). It was also significantly associated with IOP ≥ 22 mmHg, myopia, diabetes, and hypertension (all, p = 0.001). CONCLUSIONS: Age, family history of glaucoma, hypertension, myopia, and elevated IOP were key risk factors. Targeted screening and regular eye examinations among high-risk individuals may facilitate earlier detection and help prevent or delay progressive glaucomatous optic nerve damage.