Abstract

Research Article

Is community based case detection of glaucoma relevant? Intraocular Pressure level and vertical Cup Disc ratio of participants at a screening programme in a rural setting in Nigeria

Elizabeth A Awoyesuku* and Ireju O Chukwuka

Published: 12 November, 2018 | Volume 2 - Issue 2 | Pages: 022-026

To determine the proportion of participants with elevated intraocular pressure and abnormal vertical cup disc ratio in a glaucoma screening event in a rural community in Nigeria.

Methods: 242 eyes of 121 participants at a one-day screening programme were examined. Visual acuity was accessed using Snellen literate and illiterate charts, followed by a pen torch examination of the anterior segment. The posterior segment was accessed using a direct ophthalmoscope (Welch Allyn, USA). All participants had intraocular accessed using Keeler non contact tonometer and those with significant media opacity preventing view of the posterior pole had cycloplegic examination after dilatation with 1%Tropicamide drops. Data generated was expressed as percentages and means.

Results: 121 participants (242 eyes) were examined. There were 42 males and 79 females giving a M:F ratio of 1:1.86. Age range of participants was 0-90years with a peak in the 5th decade. Mean age was 32 years. 79.3% of participants had normal visual acuity of 6/4 -6/18, while 9.5% had visual acuity worse than 6/60.

83% of eyes had intraocular pressure within normal level, <21mmHg, 12.4% within 21-30mmHg and 4.6% >30mmHg.

73.1% of eyes had Vertical Cup disc ratio (VCDR) <0.5, 10.7% had 0.5-0.7 and 6.6%>0.7. 9.6% of eyes could not be accessed due to media opacities.

Conclusion: 6.6% of participants had suspicious discs and 4.6% participants had intraocular pressures above 30mmHg. Opportunistic screening for glaucoma remains one of the important modes of case detection for glaucoma in the developing climes and should be encouraged as a way to address the scourge of this blinding disease.

Read Full Article HTML DOI: 10.29328/journal.ijceo.1001017 Cite this Article Read Full Article PDF

Keywords:

Intra ocular pressure; Rural; Screening; Vertical cup disc ratio

References

  1. Weinreb RN, Aung T, Medeiros FA. The Pathophysiology and Treatment of Glaucoma: a review. JAMA. 2014; 311: 1901-1911. Ref.: https://goo.gl/ZNtGwi
  2. Leite MT, Sakata LM, Medeiros FA. Managing glaucoma in developing countries. Arq Bras Oftalmol. 2011; 74: 83-84. Ref.: https://goo.gl/TjmZoi
  3. Quigley HA, Broman AT. The number of people with glaucoma worldwide. Br J Ophthalmol. 2006; 90: 262-267. Ref.: https://goo.gl/aUW22V
  4. Francis BA, Varma R, Vigen C, Lai MY, Winarko J, et al. Population and High Risk Group Screening for Glaucoma: The Los Angeles Latino Eye Study. Invest Ophthalmol Vis Sci. 2011; 52: 6257-6264. Ref.: https://goo.gl/Zrhzuy
  5. Hollows FC, Graham PA. Intra-Ocular pressure, glaucoma and glaucoma suspects in a defined population. Br J Ophthalmol. 1966; 50: 570-586. Ref.: https://goo.gl/Nmzpim
  6. Cedrone C, Culasso F, Cesareo M, Zapelloni A, Cedrone P, et al. Prevalence of glaucoma in Ponza, Italy: a comparison with other studies. Ophthalmic Epidemiol. 1997; 4: 59-72. Ref.: https://goo.gl/kEMdmp
  7. Ramakrishnan R, Nirmalan PK, Krishnadas R, Thulasiraj RD, Tielsch JM, et al. Glaucoma in a rural population of Southern India: the Aravind comprehensive eye survey. Ophthalmology. 2003; 110: 1484-1490. Ref.: https://goo.gl/bFqBKn
  8. Abdull MM, Sivasubramaniam S, Murthy GVS, Gilbert C, Abubakar T, et al. Causes of blindness and visual impairment in Nigeria: the Nigerian national blindness and visual impairment survey. Invest Ophthalmol Vis Sci. 2009; 50: 4114-4120. Ref.: https://goo.gl/P5J7dv
  9. Damji KF, Nazarali S, Giorgis A, Kiage D, Marcos S, et al. STOP Glaucoma in Sub Saharan Africa: enhancing awareness, detection, management, and capacity for glaucoma care. Expert Review of Ophthalmology. 2017; 12: 197-206. Ref.: https://goo.gl/zg8ZrX
  10. Maul EA, Jampel HD. Glaucoma Screening in the real World. Ref.: https://goo.gl/1FW4uL
  11. Abdu L. Epidemiological Properties of Primary Open Angle Glaucoma in Nigeria. Journal of Ophthalmology. 2013: Article ID 402739, 6. Ref.: https://goo.gl/i75ait
  12. Kyari F, Gilbert C, Blanchet K, Wormald R. Improving services for glaucoma care in Nigeria: implications for policy and programmes to achieve universal health coverage. BrJ Ophthalmol. 2017; 101: 543-547. Ref.: https://goo.gl/vmVh5Y
  13. Olawoye O, Fawole OI, Teng CC, Ritch R. Evaluation of community eye outreach programs for early glaucoma detection in Nigeria. Clin Ophthalmol 2013; 7: 1753-1759. Ref.: https://goo.gl/n9WMPu
  14. Liang Y, Jiang J, Ou W, Peng X, Sun R, et al. Effect of community screening on the demographic makeup and clinical severity of glaucoma patients receiving care in urban china. Am J Ophthalmol. 2018; 195: 1-7. Ref.: https://goo.gl/3ubGPf
  15. Jampell HD. Screening for glaucoma using intraocular pressure alone. BMJ. 2017; 358. Ref.: https://goo.gl/wf78F7
  16. Kyari F, Entekume G, Rabiu M, Spry P, Wormald R, et al. A population-based survey of the prevalence and types of glaucoma in Nigeria: results from the Nigeria national Blindness and visual impairment survey. BMC Ophthalmology. 2015; 15: 176. Ref.: https://goo.gl/1gwqie
  17. Wolfs RC, Borger PH, Ramrattan RS, Klaver CC, Hulsman CA, et al. Changing views on Open Angle Glaucoma: Definitions and Prevalences- The Rotterdam Study. Invest Ophthalmol & Vis Sci. 2000; 41:3309-3321. Ref.: https://goo.gl/tR4tuE

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