A novel approach to glaucoma screening and education in Nepal

Thapa, Suman; Kelley, Kurt H; Rens, Ger van; Paudyal, Indira; Chang, Lan

doi:10.1186/1471-2415-8-21

Cited by 21 publications

(11 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, 92.3% of those diagnosed with glaucoma‐related conditions were previously unaware of their condition, which is consistent with results from population‐based glaucoma screening in China (82%‐95.9%) . This proportion is similar to that reported in other low and middle‐income countries, including Nepal (96%) and India (92.6%), and is significantly higher than that reported in richer countries, such as Ireland (49%), Australia (51%) and the Netherlands (52.9%) . The high prevalence of undiagnosed glaucoma is likely due to a combination of poor access to healthcare and the absence of subjective symptoms until late stages of disease.…”

Section: Discussionsupporting

confidence: 89%

“…3,7 This proportion is similar to that reported in other low and middle-income countries, including Nepal (96%) and India (92.6%), and is significantly higher than that reported in richer countries, such as Ireland (49%), Australia (51%) and the Netherlands (52.9%). 6,[31][32][33][34][35] The high prevalence of undiagnosed glaucoma is likely due to a combination of poor access to healthcare and the absence of subjective symptoms until late stages of disease. In the present study, only four of 277 (1.44%) glaucoma suspects had an IOP ≥ 30 mmHg at initial screening, that is, in a range which might be symptomatic.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Integrating opportunistic glaucoma screening into general health examinations in China: A pilot study

Zhang

Sun

Liu

et al. 2019

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

Importance Under‐detection and late diagnosis are major causes of glaucoma‐related visual impairment. Cost‐effective opportunistic glaucoma screening is of great interest in the early identification and prevention of glaucoma. Background To describe the results of a health examination centre‐based opportunistic glaucoma screening and referral model. Design This single centre cross‐sectional study was conducted in a health examination centre affiliated to a tertiary hospital in Shenyang, northeastern China. Participants From 21 March to 30 September 2016, 14 367 individuals aged ≥ 30 years undergoing routine physical examinations were invited for this glaucoma screening. Methods Presenting visual acuity, non‐contact pneumotonometry and non‐mydriatic fundus photography were evaluated. Fundus photographs were classified as non‐glaucoma, possible, probable and definitive glaucoma. Participants with probable and definite glaucomatous discs or intraocular pressure ≥ 24 mmHg were referred for definitive examinations. Main Outcome Measures Detection rate of glaucoma suspects and ocular hypertension (OHT). Cost to identify a single case with suspected and diagnosed glaucoma was also calculated. Results Altogether, 277 glaucoma suspects and 327 ocular hypertension suspects were identified. Among 190 participants with probable/definite glaucomatous discs, 93 (48.9%) accepted further examination. Among these, 78 were diagnosed as glaucoma, seven as suspects and eight were excluded. Only 98 ocular hypertension suspects (30.0%) accepted further examinations: eight had primary angle closure and 23 had confirmed ocular hypertension. The cost to identify a single glaucoma suspect and definite glaucoma case were US$135 and US$857, respectively. Conclusions and Relevance This novel screening model provides opportunities to improve glaucoma detection at low cost. Interventions to improve follow‐up are needed.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Integrating opportunistic glaucoma screening into general health examinations in China: A pilot study

Zhang

Sun

Liu

et al. 2019

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

show abstract

“…In this study, we found the majority of pa ents having POAG which is similar to other studies conducted in Nepal and [8][9][10][11][12][13] other south Asian countries. The study by Dr. Sah R. P. et al was a community based cross sec onal study done in 1600 10 pa ents above 40 years in Sunsari district of Nepal .…”

Section: Discussionsupporting

confidence: 89%

Glaucoma in Community: An Opportunistic Screening in Cataract Screening Programs

Rajbanshi

2019

Birat J. Health Sci.

View full text Add to dashboard Cite

Introduction: Glaucoma is an optic neuropathy for which elevated intraocular pressure is considered as major risk factor. Glaucoma is the second most common cause of blindness after cataract. Since visual loss in glaucoma is irreversible, management strategies must be focused upon early detection and prevention of disease progression through strict control of intraocular pressure. Objectives: To estimate the ocular morbidity of glaucoma in community screening camps and to estimate the types of glaucoma. Methodology: It is a Community based opportunistic screening program. Study was carried out at community screening camps for cataract from August 2009 to August 2010. Five hundred five patients equal and above 50 years were examined in five screening camps conducted in Kathmandu valley. Glaucoma suspects were identified on the basis of shallow anterior chamber, intraocular pressure > 20 mm of Hg, abnormal frequency doubling perimetry (FDP), cup to disc ratio (CDR) >0.7:1, asymmetric CDR > 0.2:1, unhealthy NRR and the other disc findings suggestive of glaucoma. Glaucoma suspects were re-examined in tertiary eye hospital (TIO) in order to make a final diagnosis and provide treatment. Result: Out of 505, 67 glaucoma suspects were re-examined in Tilganga Institute of Ophthalmology. Number of patient diagnosed glaucoma was 17 (3.37%). Of them 9 patients (1.78%) had POAG, 4 (0.79 %) had secondary glaucoma, 3 (0.59%) had normal tension glaucoma and 1 (0.20 %) had ocular hypertension. Conclusion: Morbidity of glaucoma is very high in community and more screenings in larger scales are needed in order to decrease the burden of blindness due to glaucoma.

show abstract

“…A novel approach to screening and patient education has been adopted by TIO to promote awareness, screening and follow up of patients [37]. …”

Section: Discussionmentioning

confidence: 99%

Prevalence of visual impairment, cataract surgery and awareness of cataract and glaucoma in Bhaktapur district of Nepal: The Bhaktapur Glaucoma Study

et al. 2011

Self Cite

View full text Add to dashboard Cite

BackgroundCataract and glaucoma are the major causes of blindness in Nepal. Bhaktapur is one of the three districts of Kathmandu valley which represents a metropolitan city with a predominantly agrarian rural periphery. This study was undertaken to determine the prevalence of visual impairment, cataract surgery and awareness of cataract and glaucoma among subjects residing in this district of Nepal.MethodsSubjects aged 40 years and above was selected using a cluster sampling methodology and a door to door enumeration was conducted for a population based cross sectional study. During the community field work, 11499 subjects underwent a structured interview regarding awareness (heard of) and knowledge (understanding of the disease) of cataract and glaucoma. At the base hospital 4003 out of 4800 (83.39%) subjects underwent a detailed ocular examination including log MAR visual acuity, refraction, applanation tonometry, cataract grading (LOCSΙΙ), retinal examination and SITA standard perimetry when indicated.ResultsThe age-sex adjusted prevalence of blindness (best corrected <3/60) and low vision (best corrected <6/18 ≥3/60) was 0.43% (95%C.I. 0.25 - 0.68) and 3.97% (95% C.I. 3.40 - 4.60) respectively. Cataract (53.3%) was the principal cause of blindness. The leading causes of low vision were cataract (60.8%) followed by refractive error (12%). The cataract surgical coverage was 90.36% and was higher in the younger age group, females and illiterate subjects. Pseudophakia was seen in 94%. Awareness of cataract (6.7%) and glaucoma (2.4%) was very low. Among subjects who were aware, 70.4% had knowledge of cataract and 45.5% of glaucoma. Cataract was commonly known to be a 'pearl like dot' white opacity in the eye while glaucoma was known to cause blindness. Awareness remained unchanged in different age groups for cataract while for glaucoma there was an increase in awareness with age. Women were significantly less aware (odds ratio (OR): 0.63; 95%, confidence interval (CI): 0.54 - 0.74) for cataract and (OR: 0.64; 95% CI: 0.50 - 0.81) for glaucoma. Literacy was also correlated with awareness.ConclusionThe low prevalence of visual impairment and the high cataract surgical coverage suggests that cataract intervention programs have been successful in Bhaktapur. Awareness and knowledge of cataract and glaucoma was very poor among this population. Eye care programs needs to be directed towards preventing visual impairment from refractive errors, screening for incurable chronic eye diseases and promoting health education in order to raise awareness on cataract and glaucoma among this population.

show abstract

A novel approach to glaucoma screening and education in Nepal

Cited by 21 publications

References 23 publications

Integrating opportunistic glaucoma screening into general health examinations in China: A pilot study

Integrating opportunistic glaucoma screening into general health examinations in China: A pilot study

Glaucoma in Community: An Opportunistic Screening in Cataract Screening Programs

Prevalence of visual impairment, cataract surgery and awareness of cataract and glaucoma in Bhaktapur district of Nepal: The Bhaktapur Glaucoma Study

Contact Info

Product

Resources

About