Researchers from Al-Quds University, Palestine Polytechnic University, Hebron University, and the Palestinian Ministry of Health surveyed 741 adults across the West Bank and Jerusalem between December 1 and December 30, 2025, using an online questionnaire distributed through social media. The instrument covered sociodemographics, awareness, knowledge, attitudes, and eye-care practices, and it was translated into locally adapted Arabic and piloted with 30 respondents. The eight-item knowledge scale showed strong internal consistency, with a Cronbach’s alpha of 0.87, and knowledge was scored out of eight points with good knowledge defined as at least six correct answers. Data were analyzed in SPSS version 23 using chi-square tests and multivariable logistic regression, and the final sample far exceeded the minimum required size of 384 participants.

The headline numbers reveal a striking disconnect between recognition and understanding. Just over half of participants, 54 percent, had heard of glaucoma, a level of name recognition that actually exceeds figures reported in neighboring Jordan, where awareness stood at 38 percent, and in Riyadh, Saudi Arabia, at 37.8 percent. Yet when the researchers tested genuine comprehension, only 13.8 percent of participants demonstrated good knowledge under a strict cutoff requiring at least seven correct answers, and just 33.9 percent met the more lenient threshold of six. The mean knowledge score was a modest 3.62 out of 8, and 27.1 percent of respondents scored zero, while only 6.2 percent achieved a perfect score.

The item-level results expose precisely where public understanding breaks down, and the failures cluster around the clinical features that matter most for early detection. Only 20.9 percent of participants correctly rejected the idea that glaucoma usually announces itself with noticeable early symptoms such as pain or redness. Roughly 29 percent actively believed that misconception, and another 50 percent were simply not sure. Equally troubling, only 20.9 percent recognized that glaucoma cannot be completely cured with full reversal of vision loss. That figure compares poorly with neighboring Jordan, where 52.2 percent of participants in a prior study correctly identified glaucoma as treatable but not curable. Because the disease damages the optic nerve irreversibly, these two misconceptions together create a false sense of security that can delay diagnosis until permanent damage is done.

Knowledge of risk factors was similarly patchy. Just 49 percent of respondents knew that adults aged 40 and older face elevated risk, 44.9 percent recognized family history as a risk factor, and 55.1 percent identified diabetes, the best-recognized of the three, likely reflecting broader public health messaging about diabetic complications. On the positive side, 64.4 percent correctly understood that early treatment can prevent further vision loss, and 57 percent knew that untreated glaucoma can cause irreversible blindness. Notably, having a chronic disease was not associated with better glaucoma knowledge in this sample, despite 12.1 percent of participants reporting chronic conditions, a finding that echoes detailed knowledge results from Saudi Arabia even where raw awareness differed.

Who understood glaucoma best was one of the study’s most telling findings. Prior awareness of having heard of the disease was by far the strongest predictor of good knowledge, with an adjusted odds ratio of 7.89, meaning participants who had previously encountered the term were nearly eight times more likely to answer knowledge questions correctly. But even within that group, only 22.8 percent achieved good knowledge, underscoring that hearing a disease name and understanding its behavior are two very different levels of health literacy. Age, education, and geography also mattered. Participants aged 55 and older had substantially lower odds of good knowledge compared with those aged 18 to 24, with adjusted odds ratios as low as 0.06 under the strict definition, and those with only a high school education scored significantly below bachelor’s degree holders. Urban residents had nearly double the good-knowledge rate of rural villagers and camp residents, 17 percent versus 8.7 percent, an independent association confirmed in regression analysis, and the gap likely reflects the concentration of healthcare services and health campaigns in cities.

The behavioral consequences of these knowledge gaps show up plainly in the eye-care data. Only 26.9 percent of participants had undergone a comprehensive eye examination within the preceding year, nearly a quarter reported never having had any such examination, and 35.1 percent had never been examined at all. Perhaps most revealing, having previously had an eye exam was not significantly associated with better glaucoma knowledge, which the authors interpret as evidence that routine clinical visits in Palestine are not being used to educate patients about the disease. Intentions, by contrast, tracked knowledge closely: participants who said they would definitely follow a provider’s recommendation for screening had a good-knowledge rate of 16.3 percent, compared with 3.8 percent among those who would probably not go and zero percent among those who would definitely not go, a statistically significant association.

The study is the first to assess glaucoma awareness in the general Palestinian population, and its findings sit within a global pattern of poor eye-health literacy. Comparable surveys have found that only 13.1 percent of participants in the Maldives recognized glaucoma’s potentially asymptomatic course, while studies in rural North India and Germany documented similar misconceptions that glaucoma must cause pain or blurred vision to be present. This convergence across widely different health systems suggests the problem is structural rather than local: glaucoma’s asymptomatic progression defeats the intuitive human strategy of waiting for symptoms before seeking care. The international data, including regional reports that up to 36 percent of primary open-angle glaucoma patients and 70 percent of primary angle-closure glaucoma patients were already blind at examination in some population-based studies, illustrate what happens when detection depends on symptom recognition.

The authors are candid about their study’s limitations. The non-probability, voluntary-response online sampling means the sample skewed young, with 49.9 percent of participants aged 18 to 24, highly educated, with 62.1 percent holding bachelor’s degrees, and urban, with 61.3 percent living in cities. Because those same characteristics were associated with better knowledge, the observed figures likely overestimate the true knowledge levels of the broader Palestinian adult population, and the true gaps among older, rural, and less educated groups may be even wider than reported. The authors emphasize that the prevalence estimates should not be read as population-representative, though the internal associations between demographics and knowledge remain robust and warrant confirmation in probability-sampled studies.

The practical implications are clear. Awareness campaigns that stop at teaching the name of the disease are not enough, the researchers argue, because fewer than one in seven people who recognize the term understand the disease’s silent progression, its irreversibility, or who is at risk. They propose embedding glaucoma education into routine clinical consultations, training ophthalmologists and primary care physicians to discuss the disease at every visit, and deploying community health workers and mobile screening programs to reach older adults, rural residents, and people with lower educational attainment, the very groups whose knowledge scores were lowest and whose risk of preventable blindness is highest. Given that glaucoma is a leading cause of irreversible blindness worldwide, affecting more than 3.6 million blind individuals globally, closing the gap between knowing the word and knowing the disease may be one of the most cost-effective interventions available to protect sight in Palestine and beyond.

Subject of Research: Public awareness and knowledge gaps regarding glaucoma among adults in Palestine

Article Title: Knowledge gaps and practices for glaucoma among adults in Palestine: a cross-sectional study

Article References: Knowledge gaps and practices for glaucoma among adults in Palestine: a cross-sectional study. (n.d.). https://doi.org/10.3389/fopht.2026.1953940

Image Credits: AI Generated

DOI: 10.3389/fopht.2026.1953940

Keywords: glaucoma, Palestine, eye health, public awareness, blindness prevention, cross-sectional study, health literacy, screening, optic neuropathy, risk factors, West Bank, public health