The types and treatment of glaucoma among adults in North Eastern part of Nigeria

Abstract

Objective: To assess the pattern of presentation and management of
glaucoma at the institution.
Design: A Retrospective analysis of all adult glaucoma that presented
between February 2002 and July 2007.
Setting: The Study was carried out at the Federal Medical Centre,
Azare, a tertiary health facility.
Participants: Included in the study were patients Aged  ≥ 20 years
with intraocular pressure (IOP)  ≥ 22mmHg who had records of cup:
disc ratio (CDR) Visual acuity (VA) at least on presentation. Exclusion criteria: presence of other visual impairing diseases such as diabetic /hypertensive retinopathy, corneal opacities, , and cataract. Patients whose diagnosis was not confirmed by an ophthalmologist.
Outcome Measures: Age, sex, IOP, CDR and VA at presentation and
at follow up visits, type of treatment offered. Central visual fields
(CVF) assessment and gonioscopy were carried out in the course of
the study since there was no records of such investigations.
Results: 157 eyes of 82 patients satisfied the inclusion criteria, 53 of
whom were males (64.6%). The mean age was 50.8 (ranged 20 – 83)
years. The presenting VA was normal in (38.9%); impaired in
(9.6%); severely impaired in (9.6%); and blind in (42.0 %).
CDR of 0.2 to 0.5 was found in (5.7%) and 0.6 to 0.7 in (9.6. %) and
0.8 or greater in (84.7%). The mean presenting IOP was 37.6 mm
Hg. 126 eyes of 69 patients were treated with anti-glaucoma
medications. Trabeculectomy was performed in (14.0%) only.
Conclusion: Glaucoma presented at advanced stages in the centre.
There was a low rate of surgical treatment.

Key Words: Adult Glaucoma Presentation, Pattern, Treatment, Nigeria