POAG is a severely debilitating disease in West Africa. Currently, many patients seem to be misclassified as having POAG who in fact have CACG. Improved examination techniques, including routine gonioscopy, would increase diagnostic accuracy and improve treatment strategies. The incidence of Myocilin mutations in this group of individuals is similar to that found in other populations around the world. Myocilin plays a limited role in the pathogenesis of POAG in this population.