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

Outcomes of Early Surgery in Children under Four Years Old with Large Angle Intermittent Exotropia

Purpose@#To find out the significance of early surgery in children of 4 years old and under with large angle intermittent exotropia of 35 prism diopters (PD) and more by examining the results of bilateral lateral rectus recession surgery and factors influencing the surgical outcome. @*Methods@#It was a retrospective study of patients who underwent bilateral lateral rectus muscle recession surgery between 2006 to 2016 with intermittent exotropia greater than or equal to 35 PD and who were able to follow-up for at least 2 years after surgery were divided into two groups based on age of 4 years old. The surgical motor success was defined as exodeviation less than 10 PD, esodeviation less than 8 PD. The angle of deviation, binocular function, best corrected visual acuity, and amount of corrected PD per lateral recession (PD/mm) were compared at each observation point after surgery. @*Results@#The motor success of bilateral rectus muscle recession surgery was 85% in children of age 4 years and under, 65.5% in age over 4 years. Success rate of early surgery was 1.3 times higher in younger age group, but there was no statistical meaning. The complication of surgery after 2 years of follow up was less in younger group-the rate of recurrent exotropia was 15% in younger group, 31.3% in older group and the rate of consecutive esotropia was 0% and 3.1%, respectively. Stereoacuity after 2 years of surgery was not fall behind in younger group compared to older group. @*Conclusions@#It is possible to obtain good surgical results by performing early surgery rather than hesitating to operate due to the younger age in patients younger than 4 years old with large angle exotropia of 35 PD and more for long-term follow up and efficient patient management.