Background: Glaucoma is a chronic optic neuropathy and a leading cause of irreversible blindness worldwide. In developing countries, patients often present at advanced stages due to lack of awareness and limited access to eye care services. Identifying the factors contributing to delayed presentation is essential for early detection and prevention of vision loss.

Objective: To determine the reasons and risk factors associated with delayed presentation among glaucoma patients attending a tertiary care hospital in Quetta, Pakistan.

Methods: A cross-sectional study was conducted at the department of Ophthalmology, Bolan Medical College / Helpers Eye Hospital Quetta, over six months, from June, 2020 to November, 2020, involving 250 newly diagnosed glaucoma patients. Data were collected using a structured questionnaire covering demographic, socioeconomic, and clinical variables. Delay in presentation was defined as diagnosis at an advanced stage or symptom duration exceeding six months before consultation. Data were analyzed using SPSS version 25.0, applying descriptive statistics and Chi-square tests to assess associations, with a significance level of p < 0.05.

Results: The mean age of participants was 56.8 ± 12.4 years; 58% were male and 64.8% resided in rural areas. Over half of the patients were illiterate (54%) and from low socioeconomic backgrounds (56.8%). Advanced-stage glaucoma at presentation was observed in 51.2% of cases. Significant associations with delayed presentation were found for rural residence (p = 0.001), low education level (p = 0.003), and low socioeconomic status (p = 0.002). The most common reasons for delay were lack of awareness (44.8%) and financial constraints (29.2%).

Conclusion: Delayed presentation of glaucoma remains common and is strongly linked to socioeconomic and educational disparities. Enhancing public awareness, strengthening primary eye care, and improving accessibility to ophthalmic services are critical for reducing glaucoma-related blindness.

Keywords: Glaucoma, delayed presentation, risk factors, awareness, socioeconomic status