Clinico-Social Profile of Patients Presenting with Primary Open Angle Glaucoma – A Retrospective Study from Paschim Midnapore, West Bengal

Abstract

BACKGROUND Glaucoma is the second most leading cause of visual loss in the world. Different socio epidemiological parameters like gender, age, socio-economic status, educational status etc. has been directly linked to occurrence of glaucoma in previous studies. Review of the western literature showed that the risk factors associated with glaucoma were high intra ocular pressure (IOP), low blood pressure, low ocular perfusion pressure, narrow anterior chamber angles, thin corneas, pseudoexfoliation, a low body mass index (BMI), and myopia. We need to evaluate the clinical and epidemiological factors affecting primary open angle glaucoma. METHODS Records of patients with a diagnosis of primary open-angle glaucoma (POAG) were studied. All data, addressing demographics (gender, age and skin colour), socioeconomic status, educational status, emotional status and clinical information concerning risk factors for developing glaucoma (family history of glaucoma, hypertension and diabetes mellitus) and any treatment history (e.g., corticosteroid intake) were noted. Findings from visual acuity examination, refraction, detailed anterior segment examination by slit lamp, fundus examination with 90 D, gonioscopy, applanation tonometry, VF examination by automated perimetry and A-scan USG were also carefully taken into account. RESULTS A total 920 patients were enrolled of which 67.94 % were males and 57.6 % were from urban population. 18.7 % cases had positive family history. Most of the patients came from lower and middle-income group (43.48 % and 48.37 % respectively). Cup-disc ratio of majority of eyes was found to be more than 0.30 (97.29 %). Different grades of disc changes and field changes were noted. Cupdisc ratio asymmetry of more than 0.20 was found in 355 (38.59 %) eyes. Paracentral and / or arcuate scotoma was detected in 585 eyes (31.80 %). CONCLUSIONS Understanding the socio-demography and socio-economy helps in early diagnosis and better assessment of the disease severity in POAG. KEYWORDS Glaucoma, POAG, CDR, Visual Fields