Visual disability in Newly Diagnosed Primary open Angle Glaucoma (POAG) Patients in a Tertiary Hospital in Nigeria

Abstract

Background: Glaucoma remains the second leading cause of blindness worldwide and the highest cause of irreversible blindness worldwide. In Nigeria, Glaucoma accounts for 16% of blindness and primary open angle glaucoma is the most prevalent clinical type.
Aim: The aim of this study is to assess the visual disability resulting from glaucoma in newly diagnosed POAG patients in University of Port Harcourt Teaching Hospital.
Materials/Method: This is a retrospective study of newly diagnosed glaucoma patients referred from the general ophthalmology clinic to the glaucoma clinic over a 12 month period (January-December 2010). All patients had a glaucoma workup including Snellen distant visual acuity, slit lamp examination, Goldman applanation tonometry, gonioscopy, dilated fundoscopy with +78 diopter lens as well as perimetry. All examinations were carried out by both authors. Patients with other co-morbidities such as cataract and retinal/macular pathologies were excluded from the study.
Results: A total of 98 patients were reviewed. There were 34 males and 27 females, giving a male to female ratio of 1.3:1.The average age was 54.2 years and most patients (>80%) were in the 40-59 year age group. Of the 98 patients reviewed, 62.2%had POAG. 30 patients were blind by distant visual acuity criteria while 45 patients were blind by central visual field criteria.
Conclusion: POAG is the most prevalent clinical subtype of glaucoma in Nigeria and sub-Saharan Africa. Paucity of symptoms in early stages of the disease and late presentation is a characteristic finding in our clinical environment. Our study showed that POAG in our environment is associated with marked visual disability at the time of presentation.

Keywords: Visual disability, POAG, Tertiary Hospital, Nigeria