Glaucoma is a multifactorial optic degenerative neuropathy characterized by the loss of retinal ganglion cells. It is a combination of vascular, genetic, anatomical, and immune factors. Glaucoma poses a significant public health concern as it is the second leading cause of blindness after cataracts, and this blindness is usually irreversible. It is estimated that 57.5 million people worldwide are affected by primary open-angle glaucoma (POAG). People over 60 years of age, family members of those already diagnosed with glaucoma, steroid users, diabetics, as well as those with high myopia, hypertension, central cornea thickness of <5 mm, and eye injury are at an increased risk of glaucoma. By 2020, it is expected that approximately 76 million people will suffer from glaucoma with that number estimated to reach 111.8 million by 2040. In this article, we perform an extensive literature review focusing on the epidemiology of glaucoma and try to determine the number of people affected; we categorize them by sex, location, and level of income. Furthermore, we strive to estimate the future projection of the disease in the next 20 years (2040) while determining the disease burden, including the cost involved in treating and preventing the disease and the disease and disability projection of glaucoma.

The purpose of this review is to analyze factors that influence individuals' decisions to participate in clinical trials focusing on racial and ethnic disparities that exist in clinical trials. These factors are then used to develop a survey that may be used in a clinical setting to further understand specific factors affecting participation. A comprehensive search of electronic databases was carried out for publications from 2010 to 2021 using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After reviewing the data, the predominant factors that were encountered in the search were then commented upon and reviewed to create an evidence-based questionnaire. ​​​​Using the comprehensive search, factors that affect clinical trial participation were identified. These factors were then used to create a comprehensive, evidence-based questionnaire to be implemented in a clinical setting to conduct and analyze the factors impacting participation in clinical trials. ​​​​​​​Understanding the factors that primarily impact an individual's decisions to participate or not participate in a clinical trial allow researchers to implement changes to decrease the hesitancy regarding participation.

Glaucoma will increase in significance as a public health problem over the next three decades as the size of the aging US population grows more significant. Because glaucoma is more prevalent among African-Americans and Hispanics, and these groups will soon outnumber Caucasians. Therefore, it is even more imperative that a referral for screening protocol for high-risk groups be implemented as the standard of care. At least half of those with glaucoma do not know they have it, and the impact on the quality of life for those whose glaucoma progresses to visual impairment or blindness is significant. Without screening, glaucoma is likely to burden many families, particularly the underserved and society, unduly. Education for the public, those at increased risk, and their physicians about glaucoma, the importance of objective screening, and early treatment even for those with no symptoms will be critical toward the success of any screening protocol.

Age-related macular degeneration (AMD) is a leading cause of blindness, and elucidating its underlying disease mechanisms is vital to the development of appropriate therapeutics. We identified differentially expressed genes (DEGs) and differentially spliced genes (DSGs) across the clinical stages of AMD in disease-affected tissue, the macular retina pigment epithelium (RPE)/choroid and the macular neural retina within the same eye. We utilized 27 deeply phenotyped donor eyes (recovered within a 6 h postmortem interval time) from Caucasian donors (60–94 years) using a standardized published protocol. Significant findings were then validated in an independent set of well-characterized donor eyes (n = 85). There was limited overlap between DEGs and DSGs, suggesting distinct mechanisms at play in AMD pathophysiology. A greater number of previously reported AMD loci overlapped with DSGs compared to DEGs between disease states, and no DEG overlap with previously reported loci was found in the macular retina between disease states. Additionally, we explored allele-specific expression (ASE) in coding regions of previously reported AMD risk loci, uncovering a significant imbalance in C3 rs2230199 and CFH rs1061170 in the macular RPE/choroid for normal eyes and intermediate AMD (iAMD), and for CFH rs1061147 in the macular RPE/choroid for normal eyes and iAMD, and separately neovascular AMD (NEO). Only significant DEGs/DSGs from the macular RPE/choroid were found to overlap between disease states. STAT1, validated between the iAMD vs. normal comparison, and AGTPBP1, BBS5, CERKL, FGFBP2, KIFC3, RORα, and ZNF292, validated between the NEO vs. normal comparison, revealed an intricate regulatory network with transcription factors and miRNAs identifying potential upstream and downstream regulators. Findings regarding the complement genes C3 and CFH suggest that coding variants at these loci may influence AMD development via an imbalance of gene expression in a tissue-specific manner. Our study provides crucial insights into the multifaceted genomic underpinnings of AMD (i.e., tissue-specific gene expression changes, potential splice variation, and allelic imbalance), which may open new avenues for AMD diagnostics and therapies specific to iAMD and NEO.

Introduction: Visual impairment impacts millions of people around the world, with the vast majority of problems being treatable. Disadvantaged communities are unable to utilize the same resources to treat these problems due to a lack of knowledge or resources, in addition to the presence of barriers preventing access. The objective of this paper is to assess eye health awareness and evaluate the barriers for individuals from disadvantaged communities in order to inform future interventions and increase access to care. Methods: This is a pilot study utilizing an online anonymous questionnaire designed to assess the demographics, eye health awareness, and access to eye care of community-based patients. A comprehensive literature review was also conducted using PubMed, Scopus, and Google Scholar to evaluate barriers to eye care and methods to improve community health outcomes. The primary goal was to improve understanding of eye health awareness and access in order to inform future strategies that can help in improving eye health awareness and service availability. Results: The results indicated that 61.2% of respondents believed that eye exams are very important, and only 7.7% of participants believed that regular eye exams are not important. The majority of participants (75%) agree that regular eye exams help prevent serious eye conditions and 84.5% believe that eye health can affect quality of life. 35.6% of participants reported they had their eyes checked by a healthcare professional within the last year, while 21.2% reported never having an eye exam. Although the majority of participants found access to eye care services in their community somewhat or very easy, 8.6% and 9.5% of participants found access difficult and very difficult, respectively. Even though 45.6% of participants reported not facing any barriers regarding access to eye care, the cost of services, long waiting times, and lack of nearby eye care providers were often cited as barriers from the remainder of the participants. Moving forward, local interventions such as mobile eye clinics, public health workshops, and telehealth are viable options to obtain an understanding of the community’s health status in addition to creating opportunities to educate and provide health screenings. Conclusion: The results indicate that although there is awareness of the importance of eye health for the majority of participants, there is still a sizable minority who have insufficient understanding. Barriers to healthcare such as cost, waiting times, and proximity to providers are common problems that are preventing many from seeking eye care. Future interventions should be created to increase access and literacy amongst the community through telehealth, mobile eye clinics, and public health workshops. Additional efforts should be taken by healthcare stakeholders to enhance care delivery, implement policies, and improve awareness.

Background/Objective: Age-related macular degeneration (AMD) is a leading cause of irreversible vision loss. Intravitreal anti-vascular endothelial growth factor (VEGF) therapy is the primary treatment for neovascular AMD. This study aimed to assess racial, ethnic, and gender representation in U.S.-based randomized controlled trials (RCTs) of anti-VEGF therapies. Methods: A systematic PubMed search identified 19 eligible RCTs. Titles and abstracts were screened, and demographic data were independently extracted and cross-verified. Chi-squared analysis was used to evaluate disparities in participant representation. Risk of bias was assessed using the ROBIS checklist. Results: Among 8003 participants across 19 trials, 92.3% were Caucasian. Asian, African American, Hispanic/Latino, and American Indian participants collectively comprised just over 5%. This underrepresentation of non-Caucasian groups was statistically significant (p < 0.01, df = 4) and not associated with study sponsorship. Gender analysis showed 59% female and 41% male participation, which was not statistically significant (p = 0.83, df = 1). Conclusions: Non-Caucasian populations remain significantly underrepresented in anti-VEGF RCTs for AMD. This raises concerns about the generalizability of trial findings to diverse populations. Future clinical trials must prioritize inclusive recruitment to ensure equitable, evidence-based care for all patients.