Knowledge and Awareness of Glaucoma: A Comparative Study Among Rural and Urban Patients in Bangladesh.

backgroundGlaucoma is a leading cause of irreversible blindness worldwide and often progresses silently until significant vision loss occurs. Early detection and timely treatment are crucial to preventing visual impairment; however, these efforts largely depend on public awareness. Assessing glaucoma-related knowledge, particularly among underserved populations, is therefore essential for developing effective prevention and control strategies. This study aimed to assess and compare the level of knowledge and awareness of glaucoma among rural and urban patients. METHODOLOGY: This comparative study included a total of 706 respondents, with 353 participants each from urban and rural areas. Participants were recruited at the Deep Eye Care Foundation in Rangpur, Bangladesh, between April and September 2023. Ethical approval was obtained from the Ethical Review Committee of the Deep Eye Care Institute, and written informed consent was secured from all participants aged 18 years and older. A bilingual questionnaire was used to collect demographic data and assess knowledge and awareness of glaucoma. Data were analyzed using IBM SPSS Statistics for Windows, Version 26.0 (IBM Corp., Armonk, NY, USA), with a p-value < 0.05 considered statistically significant.

resultsThe mean age was 39.31 ± 14.1 years for urban participants and 52.01 ± 14.2 years for rural participants. Educational attainment differed significantly, with 81 (22.9%) urban participants holding a graduate degree compared with 159 (45.0%) rural respondents having no formal education. Economic disparities were also evident: 29 (8.2%) urban families earned more than BDT 50,000 per month, whereas 186 (52.7%) rural participants earned less than BDT 10,000. Overall awareness of glaucoma was low, with only 147 (20.8%) participants familiar with the term, slightly higher among urban participants (80, 22.7%) than rural participants (67, 19%). A large proportion of both urban (288, 81.6%) and rural (287, 81.3%) respondents were unaware of or unsure about glaucoma. Rural participants reported a higher prevalence of glaucoma history (43, 64.2% vs. 11, 13.3%) and family history (36, 53.7% vs. 6, 7.4%). Medical treatment was the most commonly reported management approach, particularly among rural participants (35, 81.4% vs. 6, 54.5% urban). Knowledge of glaucoma was significantly better among urban participants, with 26 (32.5%) correctly identifying optic nerve involvement compared with 8 (11.9%) rural participants. Similarly, 41 (51.2%) urban respondents recognized increasing age as a risk factor, versus 11 (16.4%) rural respondents. A significant association was observed between residence and knowledge level (p < 0.001), with excellent knowledge reported in 25 (31.3%) urban participants compared with 6 (9.0%) rural participants. Overall, only 22 (15.0%) participants demonstrated good knowledge of glaucoma.

conclusionThis study demonstrates a marked disparity in glaucoma awareness and knowledge between rural and urban populations, with rural communities showing substantially lower levels of understanding. These findings highlight the urgent need for targeted, community-based eye health education and screening programs, particularly in rural areas, to enhance early detection, encourage timely treatment, and reduce preventable blindness due to glaucoma.