ABSTRACT
Purpose: To determine the economic burden of glaucoma on patients. Methods: A cross?sectional study was conducted on glaucoma patients diagnosed at least 6 weeks prior to the study and on topical anti? glaucoma medications. After consenting, patients were asked about their monthly income, education, occupation, treatment duration, drugs being used, cost of drugs, one bottle lasts for, financial dependence for treatment, glaucoma surgery, transportation means and cost, etc. Also, information regarding government reimbursement of medical costs was collected. Results: Seventy?four patients aged 60.18±11.5 years (40 males and 34 females) were enrolled. Majority were retirees (37.84%) and Homemakers (29.73%). Fifty (68%) participants didn’t earn anything. Sixty?three patients had bilateral involvement and 52.70% were on treatment for >3 years. Prostaglandin analogs were most commonly used drugs (34.21%). Average cost of medications and travelling was ?669.46 per month and ?203.38 per visit respectively. Majority were financially responsible for their own treatment (62.16%). Patients had an average monthly income of ?7108.11. Low?income group spent 26.08 % of their monthly salary on glaucoma treatment. Low?moderate and high? income group spent 5.17% and 1.50% of their monthly income respectively. Only 4.05% were covered by government reimbursement. Gender (P=0.019), occupation (P=0.010), whether undergone surgery (P=0.007), whether accompanied (P=0.027), hours lost during each visit (P=0.016) and treatment impression (P=0.027) showed statistical significance when associated with financial dependence. Conclusion: Treatment should be modified according to the patient’s socioeconomic status. Glaucoma education programs and screening camps in remote areas would help in early detection of the disease
ABSTRACT
Purpose: The aim of the study was to survey keratoconus management by optometrists in India. Methods: A validated online survey questionnaire was circulated to all optometrists from India who had completed 4 years of optometry programs. Practitioners were asked general contact lens practice questions and keratoconus management?related questions. For analysis, data were imported into SPSS (IBM Corp. 2011). Results: A total of 159 optometrists responded to the questionnaire, of whom 10.7% of practitioners had >10 years of experience and the remaining 89.3% had <10 years. Only 45.3% of respondents had corneal topography in their practice. Approximately 55% of practitioners prescribed gas permeable (GP) lenses. Around 77.4% of practitioners considered that a combination of multiple factors is necessary for keratoconus investigations. In addition, 91.8% of practitioners used the keratoconus severity classification. Also, 73% of practitioners consider that GP contact lens (CL) fitting is more difficult in keratoconic eyes than in healthy eyes. The average number of GP diagnostic lenses used in keratoconus CL fittings was 3.93 ± 1.92. A majority of practitioners calculate back optic zone radius (BOZR) using the manufacturer’s guidelines (based on manual keratometry [39.6%] or based on corneal topography [40.3%]). Around 40.3% of respondents prefer to refer patients to another optometrist for CL fitting before consulting an ophthalmologist for surgical intervention. Finally, half of the respondents participate in co?management with ophthalmologists after surgical treatment (54.1%). Conclusion: This study provides details about the management of keratoconus by optometrists in India. Keratoconus patient care could be improved with new evidence?based guidelines for the management and referral of these patients that would provide guidance on GP CL fitting procedures. Furthermore, it determines referral criteria and enhances co?management between optometrists and ophthalmologists.