ABSTRACT
Introduction: Glaucoma is an idiopathic, progressive optic disc neuropathy complicating into irreversible blindness if untreated. Early diagnosis by screening cases from high-risk populations has a pivotal role in managing this major public health problem with high treatment expenditures. Objectives: To identify the various ocular and non ocular risk factors of glaucoma and to identify the drug prescription pattern among glaucoma patients. Method: This was an observational, case-control study including 165 adult Glaucoma patients on treatment as cases and 165 age and sex-matched healthy individuals as controls, all of which were randomly selected from the patients visiting a tertiary eye care center. Various risk factors, drug prescription pattern and symptoms of the patients were recorded and analyzed. Results: A total of 165 adult Glaucoma patients and age and gender matched 165 controls were enrolled. Majority of the patients (41.21%) complained of blurring of vision at the time of study. The Odds ratios for Family history, Hypertension, Diabetes Mellitus, Migraine, Sleep apnea and Smoking showed strong association as risk factors for Glaucoma and the differences between the two groups were statistically significant (p value < 0.05). The mean number of drugs per prescription ± SD was 1.88 ± 0.79. Fixed drug formulations were prescribed in 42.4% patients. All the drugs were prescribed by their brand names and majority of them were in the form of eye drops. Conclusion: Primary Open Angle Glaucoma (POAG) was the most common subtype in the study. Age, Family history, Myopia, Hypertension, Diabetes Mellitus, Sleep Apnea, Migraine, Corticosteroid usage and Smoking emerged as putative risk factors. In consistence with present guidelines, Prostaglandin analogs were the most prescribed antiglaucoma drugs. The considerable proportion of asymptomatic cases (23%) suggests the need for periodic eye examinations to detect glaucomatous changes at an early stage.
ABSTRACT
Introduction : Glaucoma is the leading cause of irreversible visual loss in world and also in India. Because of the relatively asymptomatic initial phase of the disease, it is often detected by chance and is frequently associated with extensive and irreversible damage at the time of diagnosis. Objectives: To screen for Glaucoma among patients eligible as per inclusion criteria, to classify the glaucoma cases according to clinical presentation and to correlate the occurrence of glaucoma with different variables. Method: The present study was conducted at one of the tertiary care hospitals of Ahmedabad city during celebration of “World Glaucoma Week - 2021”. Total 1421 patients were offered opportunistic screening after oral informed consent during 6-12 March 2021, who attended the institute. After applying exclusion criteria, 945 were found eligible who underwent a comprehensive ophthalmic examination like visual acuity, intra- ocular pressure measurement, gonioscopy, optical disc and visual filed examinations were carried out as per standard protocols. Sociodemographic details, any relevant ophthalmic history pertaining to glaucoma and systemic illnesses were also assessed. The data were entered and analyzed in MS excel. Results: The incidence of newly diagnosed cases of glaucoma among opportunistic screened cohort was 36.71% (n=347). Of total newly diagnosed, the presentation as per clinical classification was as follows: Primary open angle glaucoma (POAG) - 202 (58.21%), Primary angle closure glaucoma (PACG) - 77 (22.19%), Primary angle closure suspect (PACS) – 41 (11.82%), Ocular hypertension (OHT) – 6 (1.73%), Normal tension glaucoma (NTG) – 10 (2.88%), Secondary glaucoma – 9 (7.09%) and Congenital glaucoma – 2 (0.58%). In yield, 25 (19.68%) were ?40 years and 36 (28.35%) had positive family history of glaucoma. Conclusion: Presence of stand-alone Diabetes and Hypertension or presence of both accompanying – all three conditions were found to be statistically significant determinant for occurrence of particular variety of Glaucoma. There was highly significant statistical association between cup-disc ratio level at the time of presentation and clinical variety of glaucoma