Glaucoma epidemiology in kazakhstan: Current trends

Glaucoma remains the leading cause of irreversible blindness and a significant public health challenge in the Republic of Kazakhstan. This study examines the epidemiological dynamics of glaucoma in the country over the last two decades, characterized by an alarming doubling of incidence rates from 59.1 to 135.5 per 100 000 population between 2000 and 2022. We conducted a systematic literature search of PubMed, Scopus and Web of Science, supplemented by a manual search of Kazakhstani medical journals, for studies published within a 10-year timeframe to assess the impact of the National Screening Program. Following PRISMA 2020 guidelines, 12 studies were selected for a qualitative, narrative synthesis (no statistical pooling was performed) from an initial 90 records. According to a national population-based screening study, the overall glaucoma prevalence among adults over 40 years of age was 2.37±0.17%, rising to 14.2% in the 71-75-year age group; other included studies reported a primary-care detection rate of only 0.29% and a 1.91-fold higher risk in women than men. While the 2011 integration of glaucoma screening into the National Mandatory Healthcare Program significantly improved active detection, a substantial proportion of patients are still diagnosed at advanced stages, which accounts for a 3.7-fold increase in related disability over ten years. We propose, as a hypothesis to be tested rather than a finding of this review, that the current reliance on tonometry-based screening at the primary care level creates a “diagnostic shadow”, particularly failing to capture normal-tension glaucoma cases. Similar to shifts observed in national screening for cervical and colorectal cancers, the surge in glaucoma prevalence may reflect a transition from passive to active detection. This analysis provides a conceptual framework for optimizing public health strategies in Kazakhstan by moving from reactive disability management to proactive early intervention.