Awareness and Knowledge of Glaucoma among Health Workers in Butajira General Hospital, South Ethiopia

Raising awareness and knowledge of glaucoma is a key means of enhancing people alertness, increasing regular eye screening practice, and the chance of identifying undetected cases. Health professionals other than ophthalmologists are often the first point of contact when patients seek medical advice. However, little is known about the awareness and knowledge of glaucoma among health care professionals in Ethiopia.The objective of this study was to determine general awareness and knowledge of glaucoma among health workers in Butajira General Hospital. METHODS: Hospital-based cross-sectional study was conducted at Butajira Hospital in September and October 2021 among health care providers. All health workers except those on leave and the staff in the department of Ophthalmology were included in the study. The awareness and knowledge were assessed using a self-administered questionnaire. Descriptive statistics was computed to describe the study variable, and logistic regression was conducted to see associations between dependent and independent variables. Significant associations were declared at p-values <0.05. RESULT: This study showed that 184 (91.1%) had an awareness of glaucoma among the study participants, whereas 8.9% had never heard about glaucoma. Of those who were aware, only 42% have good knowledge. Professionals who had a history of eye examinations and family history of glaucoma were about 3.0 times more likely to have good knowledge. CONCLUSION: Fifty-eight percent of clinical professionals from Butajira Hospital had no awareness at all or had poor knowledge about glaucoma. Being a physician, history of eye examinations, and having a family history of glaucoma were factors related to glaucoma knowledge

Assessment of Risk Factors for Advanced Open Angle Glaucoma Presentation among Patients Visiting Jimma University Medical Center, Jimma, Ethiopia

Glaucoma is the predominant cause of irreversible blindness, particularly the late presentation. The purpose of this study is to identify the risk factors associated with late presentation in Jimma University Medical Center METHODS: A case-control study was done among patients newly diagnosed to have open angle glaucoma (of any type) at Jimma University Medical Center from July 2014 ­ January 2019. Cases were patients/eyes diagnosed to have any type of open angle glaucoma with advanced glaucomatous disc features, whereas controls were patients diagnosed with early and moderate stages of glaucoma. RESULTS: There were 205 (116 cases and 89 controls) participants. The mean age of the participants at the time of diagnosis was 58.3±13.4yrs. Family history of blindness, presenting IOP, type of glaucoma and age were independently associated with late presentation. Patients with family history of blindness had late advanced glaucoma five times higher than those with no family history of blindness. The presence of late glaucoma among patients with presenting intra ocular pressure < 30mmHg is lower than those having ≥30mmHg (Adjusted Odds Ratio= 0.136). Primary open-angle glaucoma patients were less likely to present with advanced glaucoma than pseudo exfoliative glaucoma patients (Adjusted Odds Ratio=0.39). The chance of presenting with late glaucoma was increased by 3.4% for every one-year increment of age. CONCLUSIONS: Presence of family history of blindness, high presenting intraocular pressure, pseudo exfoliative glaucoma and old age are risk factors for late presentation of glaucoma

Screening for eye diseases in a University community in Southwest Nigeria

Background ­ University, a subset of the general population, will expectedly have common ocular problems as prevalent in the population. Knowing these problems as done through screening and health education during WSD activities in 2017 thus raise awareness for their prevention. This study was aimed at determining the types of eye defects in a university community. Methodology ­ A descriptive cross-sectional survey utilizing purposive serial selection to examine inhabitants of a university community. Socio-demographic information and detailed ocular examinations were carried out. Data analysis using SPSS Version 20 and cross tabulations with statistical significance derived using paired sample t-test at p values < 0.05 were done. Results ­ With n=140, 79(56.4 %) were males. Mean age was 26.7 + 11.5years. Majority were staffs (77.1%) with 62.1% having tertiary education. Normal vision was reported in (92.9%), while 5.7% had visual impairment with 1.4% uniocular blindness. Common ocular findings were allergic conjunctivitis (12.9%), glaucoma suspects (10.0%), Pterygium (3.6%), glaucoma/corneal opacity (2.1% respectively), and optic atrophy (1.4%). Conclusion ­Disorders seen were mostly avoidable. Incorporating eye health services into University Healthcare will control their occurrence allowing optimal job performance.

Glaucome juvenile au CHU-IOTA: aspects épidémiologiques, cliniques et paracliniques à propos de 296 cas

Introduction : Le glaucome juvénile est une entité du glaucome primitif à angle ouvert à début précoce, survenant souvent après l'âge de 3 ans et avant 35 ans. Objectif : Déterminer les aspects épidémiologique, clinique et paraclinique du glaucome juvénile. Patients et Méthodes : il s'agissait d'une étude prospective réalisée au CHU de l'IOTA de février 2012 à janvier 2013. Elle a porté sur l'analyse de 296 patients glaucomateux colligés parmi 17724 consultants de la tranche d'âge de 3 à 35 ans. Résultats : la prévalence du glaucome juvénile a été de 0,7 %. L'âge moyen était de 25 ans. Des antécédents familiaux de glaucome ont été notés chez 14,5 % des patients. Une acuité visuelle supérieure ou égale à 3/10 chez 70 % des cas. La pression intra oculaire moyenne était de 19 mmHg avec des extrêmes allant de 08 à 60 mmHg. Elle était inférieure à 22 mmHg dans 73 % des cas au premier contrôle. Le rapport Cup/Disk moyen était de 0,7 et égal à 1 chez 16 % des patients. L'angle irido cornéen était normal et ouvert à la gonioscopie chez tous nos patients (100 %). Une altération avancée du champ visuel était observée chez 14,2 % des patients. Conclusion : La prévalence de 0,7% du glaucome juvénile dans notre étude confirme la relative rareté de cette pathologie. Le principal motif de consultation était la baisse visuelle

Eye diseases in Akon payam, South Sudan

Objectives: To determine the prevalence and causes of blindness and visual impairment among patients in Akon payam, Warrap State, South Sudan.Methods and materials: This was a cross-sectional study of 862 patients conducted at Akon in the period 18 ­ 31 September 2015. The Snellen E chart was used to measure visual acuity, and all patients had a basic eye examination. Their vision status was categorized according to the World Health Organization classification. Data were entered and analyzed using SPSS version 22(IBM).Results: The age range of the study population was 3 - 86 years; 81.9% were aged 41-80 years. 50.8% were males and 49.2% were females. There were 1483 bilaterally blind eyes giving a prevalence of blindness of 86% (95% CI: 3.2497-3.3531) with prevalence of visual impairment of 3.9 %( 95% CI: 2.5001-3.0944.Cataract (59.7%) was the commonest eye disease, followed by glaucoma (15.1%), corneal dystrophy (9.3%), allergic conjunctivitis (5.5%), corneal scar (1.9%), refractive errors(1.8%) and others(6.7%). Among those who are blind cataract (66%) was the major agent with females affected more than males .It was followed by glaucoma (16.7%), corneal dystrophy (10%), corneal scar(1.8%) and the rest of agents(5.4%). The main age group affected by blindness was the 41- 80 years age group (87%) and the least was below 20 years (1.1%). There was a strong association between age and sex with the causes of blindness.Conclusion: There was equal sex preponderance with more blindness in those aged 41 years or above. Cataract and glaucoma still remained major cause of blindness in this payam. More effort is needed by the government to reduce the burden of these diseases

Practice of trabeculectomy by ophthalmologists in Nigeria

Aim: To assess the practice of trabeculectomy among ophthalmologists in Nigeria. Materials and Methods: This was a cross-sectional study in which structured, self- administered questionnaires were distributed to 80 consenting ophthalmologists present during the 2010 annual scientific session of the Ophthalmological Society of Nigeria. All consenting ophthalmologists treat glaucoma patients. Information obtained were demographic characteristics, glaucoma outpatient load, number of trabeculectomies performed in the preceding 1 year and during residency training, and factors influencing trabeculectomy practice. Data were analyzed with Statistical Package for Social Science version 16.0. Relationships between variables were tested using the Χ2 test for statistical significance. Results: Sixty-five of the 80 consenting ophthalmologists responded to the questionnaires (81.3% response rate); 32 (53.3%) were females and 28 (46.7%) were males (5 non-responders). Ages ranged from 30 to 60 years with a mean of 44 years ± SD 7.7. Only 36 (57.1%) performed trabeculectomy in the 1 year preceding the study. There was an overall trabeculectomy rate of 0.9/ophthalmologist/month. Of the 15 respondents who performed more than 15 trabeculectomies during residency, 14 (93.3%) also performed the surgery in the year preceding this study (P = 0.001). The main limitation to the practice of the procedure was patients' unwillingness to accept surgery, as identified by 50 (89.3%) respondents. Conclusions: A low trabeculectomy rate of 0.9/ophthalmologist/month was found in this study. It was significantly associated with insufficient exposure to the surgery during residency training and patients' poor acceptance of the surgery

Quality of sleep and psychological distress in glaucoma

Background: People living with glaucoma are psychologically burdened because of the threat of visual loss. Therefore, understanding the psychosocial issues and quality of sleep holds important implications for the recognition, prevention, and treatment of emotional problems among people with glaucoma. This study investigated the quality of sleep and psychological distress among people with glaucoma.Methods: This was a cross-sectional study of adults recruited over a period of 12 weeks from a glaucoma clinic of a Teaching Hospital in south-west Nigeria. The quality of sleep and psychological distress were evaluated using the Pittsburgh Sleep Quality Index and General Health Questionnaire respectively.Results: Ninety-three adults with glaucoma participated in the study. The mean age was 62.33 ± 15.25 years. Fifty-seven (61.3%) of the subjects were poor sleepers while 27 (29.0%) were psychologically distressed. Psychological distress correlated with global sleep score (r = 0.399, p = 0.000), subjective sleep quality (r = 0.341, p = 0.001), sleep latency (r = 0.245, p = 0.018) and sleep disturbance (r = 0.279, p = 0.007).Conclusion: Psychological distress and sleep disturbances were common among patients with glaucoma. Concerns about these issues should be incorporated into routine clinical evaluations of patients with glaucoma

Causes of Blindness and Career Choice among Pupils in a Blind School; South Western Nigeria

Background: The causes of Blindness vary from place to place with about 80 of it been avoidable. Furthermore Blind people face a lot of challenges in career choice thus limiting their economic potential and full integration into the society. This study aims at identifying the causes of blindness and career choice among pupils in a school for the blind in South -Western Nigeria. Materials and Methods: This is a descriptive study of causes of blindness and career choice among 38 pupils residing in a school for the blind at Ikere -Ekiti; South Western Nigeria. Results: Thirty eight pupils comprising of 25 males (65.8) and 13 females (34.2) with age range from 6-39 years were seen for the study; The commonest cause of blindness was cataract with 14 cases (36.84) while congenital glaucoma and infection had an equal proportion of 5 cases each (13.16). Avoidable causes constituted the greatest proportion of the causes 27 (71.05) while unavoidable causes accounted for 11 (28.9). The law career was the most desired profession by the pupils 11 (33.3) followed by Teaching 9 (27.3); other desired profession includes engineering; journalism and farming. Conclusion: The greatest proportion of causes of blindness identified in this study is avoidable. There is the need to create public awareness on some of the notable causes particularly cataract and motivate the community to utilize available eye care services Furthermore there is need for career talk in schools for the blind to enable them choose career where their potential can be fully maximized

Awareness and Knowledge of Glaucoma among Hospital Workers at the University of Benin Teaching Hospital; Benin City

Background: Glaucoma is a disease of public health importance. We assessed the level of awareness and knowledge of glaucoma among workers at the University of Benin Teaching Hospital; Benin City; Edo State; Nigeria. Materials and Methods: This is cross-sectional study of hospital workers at the University of Benin Teaching Hospital; Benin City. Data on demographics; awareness and knowledge of glaucoma was gathered through structured self-administered questionnaires to a random sample of workers. Statistical analyses were performed with the Statistical Package for Social Sciences 16 (SPSS Inc. 2007. SPSS for Windows; Version 16.0. Chicago) software. Chi-square test was used to assess for any statistically significant difference in the social demographic factors such as age; gender; staff category; education; and duration of employment in the hospital and awareness of glaucoma. The level of knowledge among the staff categories was also compared using the Chi-square test. Statistical significance was taken as P 0.05. Results: There were a total of 226 respondents. 93 (41.2) were in the age group of 21-30 years. 111 (49.1) were males. 168 (74.3) were aware of glaucoma. Awareness of glaucoma was higher among the paramedical staff and among workers with a higher education (P 0.001). The knowledge of glaucoma was good among 31) were aware of glaucoma. Awareness of glaucoma was higher among the paramedical staff and among workers with a higher education (P 0.001). The knowledge of glaucoma was good among 31 of those who were aware of glaucoma; fair in 31.5 and poor in 37.8. Conclusions: There is a need to educate hospital workers on glaucoma in order to raise awareness and increase their level of knowledge such that blindness prevention from glaucoma may be possible from early diagnosis and prompt treatment in these workers; their relatives; and contacts

Presentation of Glaucoma in the Greater Accra Metropolitan Area of Ghana

Background: This study addresses the prevalence and clinical presentation of patients with primary open angle glaucoma (POAG) in the greater Accra metropolitan area. Methods: This is a retrospective case series of 455 patients (813 eyes) at the Emmanuel Eye Clinic. Patients were diagnosed from May 2008 to Nov 2011. The definition of POAG conformed to the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) criteria. Information collected included basic demographic data; distribution of glaucoma subtypes; measured intraocular pressure (IOP); best corrected visual acuity (BCVA) and optic disc measurements. Results: Nearly 24 presented blind in at least one eye. The average age was 56.7 +/-16.7 years and the average IOP was 33.9 mmHg +/- 12.7 mmHg for right eyes and 33.5 mmHg +/-12.0 mmHg for left eyes. The mean vertical cup to disc ratio (vCDR) was 0.83 for right eyes versus 0.82 for left eyes. A total of 32 patients (53 eyes) were diagnosed with normal tension glaucoma (NTG). Statistically significant differences between the NTG and high tension groups included age (45.3 +/- 16.7 vs. 56.7 +/-16.7; p0.001); mean IOP (19.1 mmHg +/- 4.5 mmHg vs. 33.7 +/- 12.4 mmHg; p0.001) and mean vCDR (0.76 +/- 0.17 vs. 0.83 +/- 0.10; p0.01). Comparing age-matched NTG patients with high tension glaucoma patients showed no significant difference in vCDR. Conclusions: The clinical presentation of POAG at the Emmanuel Eye Center is characterized by elevated IOP and grossly advanced optic neuropathy. Significant differences between high tension glaucoma and NTG were identified

The Effect of Medical Therapy on IOP Control in Ghana

Background: To investigate IOP control following twelve months of continuous medical therapy in Ghana. Methods: This retrospective case series included 163 glaucoma patients diagnosed at a referral eye center between 1996 and 2006. Information collected included age; gender; IOP at presentation; six months and one year post treatment and types of anti-glaucoma medications prescribed. Optimal IOP control was defined according to results from the Advanced Glaucoma Intervention Study (AGIS); which demonstrated arrest of visual field progression in patients with IOP 18 mmHg at all visitations: Level 1 (post-treatment IOP . 21 mmHg); Level 2 (. 18 mmHg) and level 3 (. 16 mmHg). The principal outcome measure was the achievement of IOP 18 mmHg at six months and twelve month visitations. Results: One hundred sixty three patients were analyzed. These included 68 males (41.7) and 95 females (58.3). The mean age was 57}16 (median 59 years; range 7 . 95 years). There was no significant difference in age (p

Detection of early Glaucomatous Damage in Pseudo Exfoliation Syndrome by Assessment of Retinal Nerve Fiber Layer Thickness

Purpose : To detect early glaucomatous changes in pseudo exfoliative patients with normal intraocular pressure (IOP); visual field and optic nerve head appearance; by measuring retinal nerve fiber layer (RNFL) thickness using optical coherence tomography (OCT). Design : A prospective observational case-control study. Participants : Twenty non-glaucomatous (normal IOP; fundus and visual field) pseudo exfoliative patients and 20 age matched healthy control subjects. Materials and Methods : The RNFL thickness (global and four quadrants) was assessed using combined imaging system OTI (OCT/SLO) and compared with age matched normal control subjects. Results : The RNFL in patients with pseudo exfoliation syndrome (PXS) was significantly thinner in all quadrants except the nasal quadrant compared to the control group (p less than 0.05). Conclusion : Measurement of RNFL thickness by OCT is useful in detecting early RNFL damage which in turn provides clinically relevant information in detecting early glaucomatous changes in pseudo exfoliative patients

Vascular Risk Factors for Open Angle Glaucoma in African Eyes

Context : The exact patho physiological mechanizm of optic nerve damage in glaucoma is not fully understood. Aim : To assess the vascular risk factors in open angle glaucoma in African eyes. Settings and Design : Prospective multicenter hospital-based study in Edo State; Nigeria. Materials and Methods : Three hundred and twenty-two glaucoma patients and 184 control subjects were included in the study comprising 200 male glaucoma patients (62.11) and 122 females (37.89). A cohort of consecutive patients with a diagnosis of primary open angle glaucoma and age and sex matched control subjects were included in this prospective; cross-sectional; and multicenter hospital-based study conducted during the period January-June 2008. Blood pressure (BP); pulse and intraocular pressure findings were recorded and mean BP; pulse and perfusion pressure for each eye calculated. Statistical Analysis Used : Mean; standard deviations; 95confidence intervals; Welch's t test; and Fisher's exact test were calculated. Results : The mean IOP in the 644 eyes of the 322 glaucoma patients was 22.65 mmHg (SD plus/minus 11.06). The systolic blood pressure (P 0.0001); diastolic blood pressure (P 0.0001); mean arterial blood pressure (P 0.0001); pulse pressure (P 0.01); systolic perfusion pressure (P 0.01) were all significantly higher in glaucoma patients than in control. Conclusions : Higher systolic; diastolic; mean arterial BP and pulse pressure was found in Black African patients with open angle glaucoma

Prevalence of Glaucoma Suspects and Pattern of Intra-Ocular Pressure (IOP) Distribution in Ahoada-East Local Government Area of Rivers State

Background: Glaucoma is the commonest cause of irreversible blindness in the world. Some glaucoma patients start out as glaucoma suspects for years. Aim: To determine the prevalence of glaucoma suspects and pattern of intra-ocular pressure distribution in glaucoma suspects. Methods: This survey was carried out in Ahoada-East local government area (LGA) of Rivers State. The study took place in 6 communities in the LGA. Multi-stage sampling technique was used to select the study sample which consisted of 960 persons drawn from the 6 communities. Ocular examination was carried out and consisted of visual acuity; basic eye examination and direct funduscopy. Subjects with pathologically cupped discs or cup/disc asymmetry of ? 0.2 had their intra-ocular pressures (IOP) measured. Data was recorded primarily on the WHO/PBL eye examination form and entered into Epi-Info version 6 for analysis. Results: A total of 34 subjects who had vertical cup/disc ratio 0.5 had their intra-ocular pressures measured. Of this; 23 were glaucoma suspects. There were 15 males (65.2) and 8 females (34.8) and those aged 40-79 years made up 69.6of the study sample. Most eyes (97.8) had normal intra-ocular pressures (10-21mmHg) while one had an IOP of 8 mmHg. Out of 866 subjects; 23 were glaucoma suspects giving a prevalence of 2.7. Conclusion: Since glaucoma is a leading cause of irreversible blindness in the world; the availability of data on glaucoma suspects; the type of glaucoma they have and the age groups most at risk would facilitate early diagnosis and follow up thus preventing unnecessary blindness from glaucoma