Primary angle-closure glaucoma (PACG) is probably the second most prevalent cause of blindness in the east and southeast Asia regions, following cataract. In countries where cataract surgical rates are high, glaucoma is the leading cause of blindness. Primary open angle glaucoma (POAG) does occur in Asian people, probably at similar rates to that seen in Europeans. However, PACG occurs at a much higher rate in East Asians, and causes blindness at a much higher rate than POAG. Demographic factors such as old age, female sex and Chinese ethnicity consistently emerge as significant risk factors for the disease in epidemiological studies. Well know ocular risk factors, such as shallow anterior chamber depth and a thicker, more anteriorly positioned lens are as important in Asian people as in European people who develop PACG. Anterior chamber depth (both axial and limbal) are relatively effective screening tools for PACG. Use of ocular biometry to screen for PACG, and prophylactic treatment by laser iridotomy offer great promise in the search for an effective means of combating this important cause of blindness in Asia.