Screening First Degree Relatives of Persons with Primary Open Angle Glaucoma in India

Abstract

Purpose: To report the results of screening first degree relatives of persons identified with primary open angle glaucoma in a tertiary eye hospital glaucoma services.Design: A cross-sectional study of first degree relatives of persons with primary open angle glaucoma.Materials and methods: First degree relatives of patients identified with primary open angle glaucoma were invited to participate in a screening evaluation in the base hospital to detect glaucoma. All participating individuals had comprehensive eye examination including vision screening, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, frequency doubling peri-metry and dilated fundus examination. Persons with definite and suspected glaucoma were subject to full threshold automated perimetry.Results: A 514 first degree relatives of 346 persons with primary open angle glaucoma, of 4972 individuals who were invited to participate attended the screening examination (Response Rate 7%). Fifty-five percent of those who attended were males and mean age of participants was 56.8 years. Sixty-eight relatives (13.3% of those screened) were detected to have definite glaucoma. Sixty percent of those detected with definite glaucoma were siblings. Fifteen percent of siblings, 4% of off-springs and 20% of parents who attended the screening examination had definite open angle glaucoma.Conclusion: Prevalence of open angle glaucoma amongst first degree relatives of persons with glaucoma is higher than in the general population as reported in previous studies. Significant barriers, however, exist in the uptake of eye care services among relatives of persons known to have primary open angle glaucoma.How to cite this article: Rajendrababu S, Gupta N, Vijayakumar B, Kumaragurupari R, Krishnadas SR. Screening First Degree Relatives of Persons with Primary Open Angle Glaucoma in India. J Curr Glaucoma Pract 2014;8(3):107-112.

Opportunistic Screening for Glaucoma Amongst Glaucoma Patients’ First Degree Relatives who Accompanied them to Glaucoma Clinic

“…It is lower than that found in a study in the United States (14) (30.2%) with similar sample size with our study. It is, however, higher than 13.3% that was found in another study in India (5) . In our study, the prevalence of glaucoma was higher amongst offspring (13.7%) compare to siblings (5.2%) as also reported by Vegini et al (20) .…”

“…Logistical challenges on our part and the socio-economic status of most of these persons would make the adoption of that method ineffective. Rajendrababu et al (5) got only 7% response rate of those they invited for screening in India. They had an issue with logistics.…”

“…If the diagnosis is based only on symptoms, advanced irreversible vision loss is likely. Patients with POAG need to be identified early through adequate screening (5,16) . In Nigeria, many studies (17,18,19) have indicated that patients with glaucoma present late to the hospital.…”

“…Therefore, ceasing every opportunity to screen those at higher risk will help in identifying those with the disease early and treat them accordingly. Screening of family members of glaucoma patients is usually done by inviting such prospective individuals to the clinic (5,14) . Logistical challenges on our part and the socio-economic status of most of these persons would make the adoption of that method ineffective.…”

“…Screening for glaucoma is an important tool for reducing the incidence of blindness and visual impairment. Early detection of the condition in its earlier stage by effective screening will likely result in reduced morbidity and improve the quality of life (5) . Screening of the general population for glaucoma has been found to be cost ineffective because of the relatively low prevalence of glaucoma in the general population (6) .…”