Al-Merjan et al. (2005) presented the causes and incidence rates of disorders leading to blindness and low vision in Kuwait, based on the data collected by the Visual Disability Committee in a 5-year period from 2000 to 2004. Of the 826,083 people (407,871 males) registered with blindness and low vision, 39% were below the age of 20-years, 32% were between the ages of 21 and 40-years, while only about 10% were over 60-years of age. Primary open angle glaucoma was found to occur with an overall incidence rate of 0.24 per 100,000 population. The incidence varied between males (0.44) and females (0.04).

Belmouden et al. (2002) analyzed 32 Moroccan patients with primary congenital glaucoma (PCG) to study their CYP1B1 gene profiles.  Sequencing of the coding region detected two mutations in 11 of the patients.

In 2010, Hilal et al. investigated the contribution of cytochrome P4501B1 (CYP1B1) and myocillin (MYOC) mutations to primary congenital glaucoma (PCG) in 90 unrelated Moroccan families with PCG and 100 normal control individuals.  Twelve CYP1B1 mutations were identified in 43 PCG pedigrees.  The g.4339delG was the most frequent mutation detected in 31 families (34%), followed by the p.G61E in seven families (8%).

Ur'Rahman (1992) conducted a pilot study to estimate the intra ocular pressure in a random Omani population between the ages 40 and 50 years old. He found that 0.5% had definite open angle glaucoma while 2.4% of the cases with an intra ocular pressure more than 21mmHg, had positive provocative test. The author emphasized the need of generalized survey to detect early glaucoma. [Ur'Rahman J. Glaucoma survey in adult population in the age group 40-50 years. Oman Med J. 1992; 9(2):49.]

Khandekar et al. (2005) estimated the magnitude, components and determinants of noncompliance among glaucoma patients, through a cross-sectional study which included 105 glaucoma patients of Omani nationality (55.2% females and 44.8% males with mean duration of medical treatment for glaucoma of 5.43 years), randomly selected from different regions of Oman. Data on personal details and history of glaucoma, knowledge, beliefs, and the practice of glaucoma treatment was collected by a closed-end questionnaire. There were no significantly different percentages of patients in different age groups and regions, but most of them were illiterate (67.6%) and married (69.5%). Noncompliance information included discontinuation of medications, missing doses, regularity of hospital visits, maintenance of proper intervals between two medications, and the usage of proper methods of installing the drops. Factors that affected compliance (inadequate knowledge, negative attitude, the presence of co-morbidity, complexities of the medication, or improper technique for the installation of eye-drops) were analyzed with estimation of the relative risks and 95% confidence intervals. Noncompliant patients were counseled to improve their glaucoma care. In 24.8%, excellent compliance was detected (mostly with regular follow up and following dosage frequencies), with noncompliance seen in 72.5% (intermediate and poor compliance), which was mostly contributed by discontinuation of medications and not maintaining a proper interval between the medications. It was found that adequate knowledge of glaucoma and its possible complications were negatively associated with noncompliance, while no association was determined among glaucoma patients between a positive attitude and proper practice and noncompliance. Upon analyzing compliance in relation to age, gender, region of residence, educational level, marital status, and duration of treatment, no association was detected. Khandekar et al. (2005) recommended further longitudinal studies to further estimate the causes of noncompliance with glaucoma treatment in Oman, and in order to improve compliance and reduce visual impairment, they advised on improving knowledge, attitude, and practice, while making the drug regimen patient friendly.

Al-Mansouri (2002) studied a sample of patients with primary glaucoma to determine the pattern, severity, and medical risk factors associated with the condition in Qatar. A sample of affected Qatari nationals, aged over 30 years, was interviewed by means of a questionnaire as well as clinical examinations. The sample consisted of 195 patients with 352 glaucomatous eyes. Of these, 137 patients (58.4% females) were affected with POAG. There was a positive family history in 34.3% of patients with POAG and 34.5% of patients with Primary Angle Closure Glaucoma (PACG). This study population showed a surprisingly early onset of glaucoma. About 36% of patients presented with POAG in the first 50 years of life, and 21% before 40-years of age. In addition, a significant number of patients were legally blind due to glaucoma at the time of their first presentation. A total of 55 eyes with POAG had visual acuity between 6/60 and no perception of light, and 36.4% of the patients had advanced glaucomatous optic disc cupping. Compliance with administration of medical therapy was low in this population, with 47.7% of the whole series showing poor compliance. About 65% of this group showed progressive glaucoma changes. Al-Mansouri (2002) recommended the need for wide-scale health education, screening, and early detection of glaucoma in the Qatari population.

[Al-Mansouri F. The pattern and severity of primary Glaucoma in Qatar. Qatar Med. J. 2002; 11(1): 31-5.]

Andersen et al. (1996) used six polymorphic DNA markers on chromosome 1q, in a region showing tight linkage to GLC1A, in 25 Saudi Arabian families showing PCG.  Four of the families demonstrated the presence of two regions of exclusion, which spanned the entire length of the 8-cM region containing the GLC1A locus.  In the remaining 21 families, no PCG locus was shown to segregate in an autosomal recessive manner on haplotypes constructed using markers in this region.  The results of the study, therefore, revealed the exclusion of the 8cM region in each of these families.

Abu-Amero et al. (2006) sequenced the MYOC and OPTN genes and the entire mitochondrial DNA in 27 primary open-angle glaucoma (POAG) patients.  Seven patients with POAG had a sequence variant in the MYOC gene, two patients had a sequence variant in the OPTN gene, 27 different novel nonsynonymous mtDNA changes were found in patients with OPTN, but not in control subjects; twenty two of these mutations altered conserved amino acids and were potentially pathogenic.

Khan et al. (2011) studied 67 families of individuals affected with congenital glaucoma.  Of these families, 46 had a history of congenital glaucoma.  All families were consanguineous except for two, which were intra-tribal.  The patients were diagnosed based on buphthalmos, the characteristic corneal edema/scarring (typically with Haab striae), high myopia with astigmatism, and optic nerve cupping.  All of the probands were bilaterally affected and had obvious buphthalmos with corneal edema/scarring at birth.  Eight had bilateral mild ectropion uveae with partial aniridia.  One patient had an older brother with bilateral iris coloboma and juvenile onset glaucoma.  Homozygous or compound heterozygous CYP1B1 mutations were found in 91% of probands (61/67).  The most common mutation in this population was p.G61E in the CYP1B1gene, found in 46 of the 67 cases.  Two of the probands with mild ectropion uveae with partial aniridia were found to carry an N252K mutation on the CYP1B1 gene.  The authors surmised that newborn glaucoma on the Arabian Peninsula was a severe subtype of primary congenital glaucoma that typically involved mutations in the CYP1B1 gene.  The high consanguinity and birth rate that supersede founder effect could explain the allelic heterogeneity in this population.

Khan et al. (2012) studied Saudi children with unilateral primary newborn glaucoma.  Five such children who were diagnosed with unilateral non-syndromic glaucoma and had at least three years of ophthalmological follow-up were identified for this study.  The patients ranged from 3 to 9-years of age and did not have any family history of pediatric glaucoma.  Four of the patients were from consanguineous families.  None of the patients showed evidence for intraocular pressure or glaucoma in the contralateral eye, thereby confirming the unilateral nature of their disease.  Genetic analysis of the CYP1B1 gene was carried out for all the patients but no mutations were uncovered in the study.  However, one patient was found to be heterozygous for a SNP while another was heterozygous for 3 SNPs. The study suggested that unlike bilateral glaucoma, CYP1B1 mutations are not as common in unilateral glaucoma cases and the disease may have a different pathogenesis. 

AlShahrani et al. (2016) studied 490 Saudi subjects to find the frequency of allele and genotype of MTHFR C677T polymorphism in patients with primary glaucoma.  The study included 210 Saudi patients and 280 Saudi controls.  Primary open angle glaucoma was diagnosed in 144 of these patients.  The frequencies of genotype CT and allele T were significantly higher in POAG, whereas the frequencies of genotype CC and allele C were significantly lower as compared to controls, indicating that the genotype CT and allele T are associated with susceptibility to primary glaucoma.  Such an association was not seen for Primary Angle Closure Glaucoma.