Epidemiological Properties of Primary Open Angle Glaucoma in Nigeria

Abstract

Background. Primary open angle glaucoma (POAG) is progressive chronic optic neuropathy in adults in which intraocular pressure (IOP) and other currently unknown factors contribute to damage. POAG is the second commonest cause of avoidable blindness in Nigeria. Pattern of Presentation. POAG is characterized by late presentation. Absence of pain which is a driving force for seeking medical help, inadequacy of trained eye care personnel, paucity of facilities, misdistribution of resources, lack of awareness, poor education, and poverty may all contribute to this. Medical and surgical treatment options available are challenging and tasking. Screening for Glaucoma. Screening is the presumptive identification of unrecognized disease (POAG) by applying test(s) which can be applied rapidly. Such test(s) should be of high reliability, validity, yield, acceptable, and cost effective. The test should ideally be sensitive, specific, and efficient. It is difficult to select a suitable test that meets these criteria. Intraocular pressure (IOP) appears to be the easiest option. But, high IOP is not diagnostic nor does normal value exclude the disease. Health education is a possible strategy in early case detection and management. Treatment of POAG. Glaucoma treatment can either be medical or surgical (this includes laser). Considering unavailability, potency, cost, and long-term effects of medication, surgery (trabeculectomy) could be a better option. Laser trabeculoplasty is available in a few centers. Viscocanalostomy is not routinely performed. Patient education is vital to success as management is for life. Conclusion. POAG remains a cause of avoidable blindness in Nigeria. There is need for long-term strategy to identify patients early and institute prompt management. Improvement in training of eye care personnel and provision of up to date equipment is essential in achieving this goal.

B-mode sonographic evaluation of optic nerve sheath diameter and lens thickness in Nigerian adults with glaucoma

“…Glaucoma has consistently ranked second among the leading causes of blindness2,6,7 and is the leading cause of preventable, and rather unfortunately, irreversible blindness globally 2,8. The definition of this disease entity continues to evolve, allowing for continual modification of detection methods, treatment end-points and therapeutic options 9…”

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

“…As yields are low one method of screening would be to concentrate only on the detection of more advanced cases [10] since more often than not, patients present with advanced disease and accompanying sight loss in our environment [11].…”

Primary Open Angle Glaucoma Surgery in Sub-Saharan African Setting — Benefits and Challenges

“…[17] Considering the unavailability of potent, cost-effective, long-term acceptable medications, surgery can be a worthwhile option. [18] Successful surgery can be a one off expenses alternative. It ensures reduction in IOP round the clock.…”