Is glaucoma blindness a disease of deprivation and ignorance? A case-control study for late presentation of glaucoma in India

Abstract

Aim:The aim was to identify the presenting symptoms and social risk factors for late presentation of primary glaucoma in newly diagnosed cases.Materials and Methods:It was a case-control study in a tertiary eye care center in Maharashtra, India. Newly diagnosed patients with primary glaucoma were classified as cases (late presenters) where there was no perception of light in one eye or severe visual field loss affecting an area within 20° of fixation or a cup–disc (C:D) ratio ≥0.8 and controls (early presenters), presenting relative scotoma within 20° of fixation or a C:D ratio <0.8, but >0.5. All patients underwent a comprehensive ocular examination including gonioscopy, perimetry, and detailed family and social history. Occupation, education, and socioeconomic status were graded. SPSS version 12.0 was used, and univariate and multivariate logistic regression analysis was performed.Results:Gradual progressive painless loss of vision was the commonest symptom (175, 87.5%). Primary angle closure glaucoma was more common in females (P = 0.001) and lower socioeconomic groups (P = 0.05). Patients who were less educated were more likely to have late presentation of glaucoma (P < 0.001, odds ratio = 0.07; 95% CI, 0.02–0.25). Knowledge of family history of glaucoma (P = 0.80, odds ratio = 1.16; 95% CI, 0.36–3.71) and eye clinic attendance in past 2 years still resulted in late presentation (P = 0.45, odds ratio = 1.34, 95% CI, 0.63–2.82).Conclusion:Lack of education and awareness of glaucoma were major risk factors for late presentation.

Glaucoma symptom scale: is it a reliable measure of symptoms in glaucoma patients?: Table 1

“…By comparison, only 38.8% had primary angle closure glaucoma; over one-half (54%) were females. This latter finding is in accordance with a clinic-based6 and two population-based studies from India, the Andhra Pradesh Eye Disease Study7 and the Chennai Glaucoma Study 8. The median presenting better and worse eye acuity (logMAR) was 0.0 (Snellen equivalent, 20/20) and 0.30 (Snellen equivalent, 20/40) respectively.…”

Glaucoma Awareness and Self-Care Practices among the Health Professionals in a Medical College Hospital

“…Our study ichhpujani P et al, [12] adegbehingbe bO et al, [13] Komolafe et al, [14] Have not heard of the term "Glaucoma" because an intensive eye examination was not performed [15]. As a matter of fact, sources other than optometrists who have made diagnosis of glaucoma were 4.5 times likely to be late presenters [12].…”

“…As a matter of fact, sources other than optometrists who have made diagnosis of glaucoma were 4.5 times likely to be late presenters [12]. Such findings were observed in Barbados eye studies, where many patients did not know about their glaucomatous condition even after their visit to optometrists [15,16]. Since glaucoma is the silent thief of sight and is the second most common eye disease, the hospital staff must be aware of the disease in order to improvise case finding and to start treatment at an early stage.…”

Glaucoma awareness Indian military personnel: a tri-service study

“…Therefore, the assessment of awareness in the population is the first step in managing this progressive disease and forms the basis for designing and targeting screening programmes. In India, few studies had been carried out in south rural and urban population6 7 and Central India8 on glaucoma awareness; however, to the best of our knowledge, there are no published data of glaucoma awareness among the Indian Armed forces personnel who constitute a unique group consisting of people drawn from all parts of the country, yet bound together by military traditions and camaraderie. This study was carried out to assess the level of awareness and knowledge of glaucoma among the serving Indian Armed forces personnel by set of questionnaire and it also compares it studies done across globe (Table 3).…”