To determine the incidence and risk factors for primary open angle glaucoma (POAG) and ocular hypertension (OHT) in a multi-ethnic Asian population.Population based, cohort study PARTICIPANTS: The Singapore Epidemiology of Eye Diseases study included 10,033 participants in the baseline examination between 2004 and 2011. Out of them, 6,762 (response rate= 78.8 %) participated in this six-year follow-up visit between 2011 and 2017.Standardized examination and investigations were performed, including slit lamp biomicroscopy, intraocular pressure (IOP) measurement, pachymetry, gonioscopy, optic disc examination and static automated perimetry. Glaucoma was defined according to a combination of clinical evaluation, ocular imaging (fundus photo, visual field, and OCT) and criteria given by International Society of Geographical and Epidemiological Ophthalmology. OHT was defined on basis of elevated IOP over the upper limit of normal i.e., 20.4 mm Hg, 21.5 mmHg, and 22.6 mmHg for the Chinese, Indian, and Malay cohort respectively, without glaucomatous optic disc change.Incidence of POAG,OHT and OHT progression RESULTS: The overall six-year age-adjusted incidence of POAG and OHT were 1.31% (95% confidence interval [CI]: 1.04-1.62) and 0.47% (95% CI: 0.30-0.70). The rate of progression of baseline OHT to POAG at 6 years was 5.32%. POAG incidence was similar (1.37%) in Chinese and Indians and lower (0.80%) in Malays. Malays had higher incidence (0.79%) of OHT than Indians (0.38%) and Chinese (0.37%). Baseline parameters associated with higher risk of POAG were older age (odds ratio [OR] = 1.90 per decade; 95% CI:1.54-2.35, P<0.001), higher baseline IOP (OR=1.20 per mmHg; 95% CI:1.12-1.29, P<0.001) and longer axial length (OR=1.22 per mm; 95% CI:1.07-1.40, P=0.004).Six-year incidence of POAG was 1.31% in a multi-ethnic Asian population. Older age, higher IOP and longer axial length were associated with higher risk of POAG. These findings can help in future projections and guide public healthcare policy decisions for screening at risk individuals.Copyright © 2023. Published by Elsevier Inc.