This study aimed to assess the prevalence and associated factors of primary open-angle glaucoma (POAG) among adult diabetic patients in Northwest Ethiopia, 2023.

An institution-based cross-sectional study was conducted using a systematic random sampling method.

The study was conducted in the University of Gondar, Debre Tabor, Felege Hiwot, Tibebe Ghion and Debre Markos Comprehensive Specialized Hospitals in Northwest Ethiopia.

The study included 1174 adult diabetic patients aged 18 years or older who had resided in Northwest Ethiopia for more than 6 months.

The primary outcome was the prevalence of POAG among adult diabetic patients in Northwest Ethiopia, 2023. The second outcome was the associated factors of POAG among adult diabetic patients.

A total of 1134 study participants participated, with a response rate of 96.5%. The median age of the participants was 53 years, with an IQR of 37–62 years. The prevalence of POAG was 14.37% (95% CI 12.30 to 16.30). Older age (adjusted OR (AOR)=2.97, 95% CI 1.25 to 7.04), long duration of diabetic mellitus (AOR=3.54, 95% CI 2.27 to 5.51), poor blood glucose level (AOR=2.61, 95% CI 1.50 to 4.54), proliferative diabetic retinopathy (PDR) (AOR=4.91, 95% CI 2.10 to 11.46) and intraocular pressure (IOP) (AOR=9.15, 95% CI 6.01 to 13.93) were significantly associated factors with POAG.

This study revealed that the proportion of POAG among adult diabetic patients was high. Older age, long duration of diabetes mellitus, poor blood glucose level, PDR and IOP were positively associated with POAG.