Abstract
PURPOSE: To characterize the clinical, demographic, and imaging features of glaucoma among adults receiving care at Kingston Public Hospital (KPH) Ophthalmology clinic, Jamaica's largest public eye care facility. METHODS: We conducted a retrospective, cross-sectional chart review of adult glaucoma patients seen at the KPH Ophthalmology Clinic between January 2018 and March 2023. Included patients had documentation of at least two comprehensive ophthalmic examinations and one high-quality optical coherence tomography (OCT) scan (signal strength ≥ 6). Extracted data included demographics, intraocular pressure (IOP), visual acuity, OCT-derived optic nerve head and retinal nerve fiber layer (RNFL) parameters, visual field (VF) metrics, glaucoma severity, comorbidities, and self-reported treatment adherence. Comparisons were performed by age group (< 40 vs. ≥ 40 years) and sex. RESULTS: A total of 324 patients (619 eyes) were included (mean age 58.3 ± 12.3 years; 66.0% female). At presentation, 51.0% had advanced-stage glaucoma, and only 17.3% reported consistent medication use. Hypertension and diabetes were common comorbidities (80.3% and 38.8%, respectively). Mean Goldmann IOP was 22.0 mmHg, mean RNFL thickness was 75.2 ± 14.9 μm, and mean cup-to-disc ratio was 0.73 ± 0.10. VF indices demonstrated moderate functional loss, with worse mean deviation among men. Longitudinal VF data were limited; only 17% of patients had more than one documented test, limiting cohort-wide assessment of functional progression. CONCLUSION: This clinic-based characterization of glaucoma in Jamaica reveals a high burden of advanced disease at presentation, low treatment adherence, and gaps in longitudinal monitoring, supporting the need for prospective studies to develop ancestry-and region-specific OCT reference data and improve equitable glaucoma care.