Challenges of Glaucoma Management in Nigeria: a Nationwide Perspective (original) (raw)
Related papers
International Ophthalmology, 2019
Purpose To investigate the current practice on glaucoma care with the aim of highlighting its poise to tackle this emerging sight-threatening disease in Nigeria. Methods This was a cross-sectional, descriptive, population-based survey involving 88 ophthalmologists. Information on their demographic characteristics, practice profile, challenges and prospects on glaucoma care was collected using a semi-structured, self-administered questionnaire in August 2016. Data were analysed using SPSS 20. Results The participants are comprised of 46 (52.3%) males and 42 (47.7%) females, with a mean age of 42.2 ± 8.7 SD years. They were 45 (51.1%) consultants, 31 (35.2%) residents and 12 (13.6%) diplomates. Their years of practice were 8.8 ± 6.7 SD years. They worked mainly in government hospitals located at the southern part of Nigeria. The current practice was mainly comprehensive ophthalmology, 63 (71.6%). Only 2 (2.3%) had strict subspecialty practice. Others, 23 (26.1%), had combined practice. Eleven (12.5%) were glaucoma specialists and had combined practice. The majority of the participants, 57 (64.8%), were routinely diagnosed glaucoma properly. Sixty-three (71.6%) participants underwent trabeculectomy, 48 (54.5%) combined cataract surgery with trabeculectomy, 7 (8.0%) drainage implants, 5 (5.7%) laser trabeculoplasty, and 2 (2.3%) minimally invasive glaucoma surgery. Poor patients' acceptance and satisfaction, fear of complications, lengthy post-operative care and cost were the main deterrents to surgeries. Advocacy, public awareness, training of glaucoma specialists, provision of equipment and health insurance were the major recommendations on improving glaucoma care. Conclusion Given the meagre number of specialists and lack of strict subspecialty practice, optimal glaucoma care in Nigeria is still far from reality.
Prevalence and clinical profile of glaucoma patients in rural Nigeria—A hospital based study
PLOS ONE, 2021
Purpose To determine the prevalence and clinical presentation of participants with glaucoma attending a public eye care facility in Nigeria. Method Hospital based retrospective study of glaucoma participants aged 50 years and above seen over a 5-year period. Descriptive statistics summarized the demographic, clinical characteristics and treatment of the participants and determined the association of variables with gender and age. Prevalence of the glaucoma by type, and their 95% confidence intervals (CI) were also calculated. Result Of the 5482 case files that were reviewed, 995 (18.15%, 95% Cl 17.15–19.19%) had glaucoma particularly primary open angle glaucoma (11.55%, 95%CI 10.73–12.42%) and were mostly females (564, 56.7%) aged 69 ± 12 years (range, 50–103 years). In contrast to other glaucoma types, the prevalence of primary angle closure glaucoma (3.68, 95%CI 3.22–4.22) increased by 15% over 5 years. The mean intraocular pressure ranged from 15–50 mmHg but higher in females tha...
PLoS ONE, 2021
The purpose of this study was to evaluate the epidemiological and clinical profile of patients living with glaucoma and receiving care in a tertiary eye center in Ghana. This was a hospital-based retrospective study of clinical records of glaucoma patients from January 2010 to December 2019. The study involved collating demographic information of patients, clinical presentation, and the management of glaucoma. A total of nineteen thousand (19,000) charts were retrieved from the eye center’s archives. Out of these, 660 (3.5%) records of patients qualified for the study and were analyzed. There were 398 (60.3%) males and 262 (39.7%) females. Their ages ranged from 9 to 86 years (mean age = 47.30; SD ± 16.86 years). The averages of ocular parameters of 1,320 eyes (660 patients) were visual acuity = 0.26 ± 0.55 logMAR; intraocular pressure: 17.31 ± 6.11 mmHg; cup-to-disc ratios: 0.67 ± 0.17 D; and the average retinal nerve fibers thickness was 95.03 ± 21.74 μm. The mainstay of treatment...
2013
"Abstract Background: Inability to read materials on the blackboard can profoundly affect a child's participation and learning in the classroom. Therefore, early vision screening, and follow-up if necessary, would bring parents' attention to their child's visual status. Aim: To determine the causes of visual impairment among secondary school students in Calabar metropolis. Methods: It was an observational study conducted over three month. Four schools in Calabar metropolis were stratified and subjects recruited by multi-stage simple random technique. Subjects with visual acuity <6/9 in at least one eye were considered to have failed the vision screening test and were subsequently refracted. Data was analyzed using the Statistical Package for Social Sciences, version 15.0(2008). Results: A total of 1,175 students participated in vision screening, males were 535 and females were 640 (M:F= 1:1.2) with a mean age of 13.86+1.5 (95% Confidence Interval, [CI] = 13.35-14.36). Of the 81(6.9%) students with VA <6/9 who meant the criterion for refraction, 61(5.2%) were refracted to at least 6/9 in both eyes while the remaining 20(1.7%) had pathology or amblyopia as the cause of reduced vision. The prevalences of causes of visual impairment were, in descending order, refractive errors 61(5.2%), presumed ocular toxoplasmosis 7(0.6%), amblyopia 4(0.34%), retinitis pigmentosa 3(0.3%), pigmentary maculopathy and degeneration 3(0.3%), corneal leucoma 2(0.2%), optic disc coloboma 1(0.08%). Conclusion: uncorrected refractive error was the commonest cause of visual impairment among students in Calabar metropolis. Keywords: Ocular toxoplasmosis, refractive errors, school children, visual impairment"
Ophthalmology research: an international journal, 2022
Background: Primary Open Angle Glaucoma has been noted to be more prevalent and aggressive in blacks. Treatment of glaucoma involves lowering of intraocular pressure (IOP) to a targeted level where further glaucomatous damage is unlikely. The aim of this study was to determine sociodemographic factors and clinical history among primary open angle glaucoma (POAG) patients on medical treatment at the glaucoma clinic of Enugu State University of Science and Technology Teaching Hospital Parklane (ESUTTHP), Enugu with a view for better patient management. Methods: The study was a hospital based cross sectional study on POAG patients on medical treatment attending the eye clinic of ESUTTHP, Enugu. Patients were selected by simple random sampling. Their socio-demographics and clinical history were obtained using an intervieweradministered questionnaire. Data analysis was done using SPSS version 20 (U.S.A). Categorical variables were presented in percentages. Results: A total of 130 POAG patients on medical treatment were interviewed comprising of 56
BMC Ophthalmology, 2023
Background Ghana and Nigeria are the two countries in Africa that currently run the Doctor of Optometry (OD) program in sub-Saharan Africa (SSA). Optometrists in these countries are licensed to provide glaucoma care. Despite the clinically relevant practice guidelines for glaucoma, there is no data on the practice patterns for glaucoma eye care in SSA, a region with the highest prevalence of glaucoma. This study aimed to profile glaucoma diagnosis adherence to practice guidelines among optometrists in two neighbouring anglophone countries (Nigeria and Ghana). Methods A web-based cross-sectional survey of practising optometrists was conducted in both countries. Each country data was weighted to reflect the total number of licensed and practising optometrists at the time of this survey. Descriptive analyses were performed against demography and practice factors using survey commands to adjust for sampling weights when estimating confidence intervals (CI) around prevalence estimates. Simple and multiple logistic regression analyses were performed to identify factors associated with glaucoma diagnosis. Results A total of 493 optometrists (238, 48.3% and 255, 51.7%) from Ghana and Nigeria respectively, responded to the survey-the first to document and compare the glaucoma diagnostic criteria between optometrists in Ghana and Nigeria. More Ghanaian than Nigerian optometrists diagnosed glaucoma and over 90% in both countries reported that they frequently performed either tonometry, visual field testing, or fundus examination during glaucoma diagnosis. Ghanaian optometrists were significantly more likely to diagnose glaucoma than Nigerian optometrists (adjusted odd ratio, AOR = 6.15, 95%CI:1.63-23.15, P = .007). Optometrists who have practiced for more than 10 years (AOR = 7.04; 95%CI:1.74-28.47, P = .006) and private practice optometrists (AOR = 3.33; 95%CI:1.13-9.83, P = .03) were more likely to diagnose glaucoma. † Stephen Ocansey and Edgar Ekure co first authorship.
Glaucoma in southwest Nigeria: clinical presentation, family history and perceptions
2014
Knowledge of the presentation pattern of glaucoma helps in providing more understanding of the disease, leading to better control. The aim of this study was to determine the presentation pattern among newly diagnosed glaucoma patients in Lagos, Nigeria. This was a multicenter cross-sectional survey of newly diagnosed glaucoma patients, recruited over a fourweek period. Socio-demographic characteristics, presenting history, awareness and perception on glaucoma, and basic examination findings were obtained. A total of 208 patients, including 90 (43.2 %) females with a mean age of 53.9 years were recruited. One hundred and forty-three (68.7 %) were self-referred patients with a mean duration of symptoms of 2.6 years. Fifty-five (26.4 %) patients gave a history of glaucoma in at least one family member. Ninetyfive patients (45.7 %) were aware that glaucoma can cause visual loss, but 69 (72.6 %) out of these believed the visual loss is reversible. Seventy (33.7 %) patients had been previously diagnosed with glaucoma elsewhere. From the 208 patients, 35.5 % had visual impairment (presenting visual acuity [VA] of\6/18 in the better eye), while 15.5 % were blind (presenting VA in better eye\3/60). Lack of glaucoma awareness, positive family history and illiteracy were associated with late presentation of glaucoma. Late presentation is still a major concern among glaucoma patients in Southwest Nigeria, and there is a need to intensify present efforts aimed at increasing public awareness, emphasising the irreversible nature of the disease, as well as encouraging at-risk groups such as first-degree relatives to go for screening.
Nigerian journal of ophthalmology, 2017
Global studies indicate glaucoma treatment can preserve valueable vision, especially when commenced in its early stage and sustained. Despite glaucoma being responsible for blindness in thousands of Nigerians and accompanying disruption of their flourishing lives, Nigeria's funding glaucoma would not be easy to accomplish. This essay analyses opponents' arguments against Nigeria's funding glaucoma treatment. These include an inherent complexity of glaucoma, inadequate healthcare resources, the individual with glaucoma factor, and economic reason.
2020
Purpose: To assess the eye care practices, knowledge and attitudes of glaucoma patients identified at community eye outreaches (CEO) in Nigeria. Methodology: This was a mixed method study. The quantitative component was a cross sectional survey of patients with suspected glaucoma identified at routine CEO in South West Nigeria. Surveys were administered by trained personnel and gathered information on knowledge and attitudes toward glaucoma. The qualitative component consisted of structured interviews with providers to assess their knowledge and perspectives of glaucoma patients’ attitudes and behaviors. Results: A total of 1881 patients were screened at 24 outreaches in South West Nigeria, among which 120 glaucoma cases/suspects were identified. Fifty-six (46.7%) of the glaucoma patients were aware of glaucoma and only 39 (32.5%) patients could answer at least one knowledge question correctly. Predictors of awareness of glaucoma were minimum of secondary school education (adjusted ...
Cost Analysis of Medical versus Surgical Management of Glaucoma in Nigeria
Journal of ophthalmic & vision research, 2010
To analyze the cost of glaucoma medical therapy and compare it with that of surgical management in Nigeria. The cost of glaucoma drugs and that of surgical therapy in patients who attended the eye clinic of the University of Benin Teaching Hospital, Benin City, Nigeria, between December 2002 and November 2008 were calculated over a 3 year period of follow-up. Costs of medical and surgical therapy were compared based on November 2008 estimates. One hundred and eight patients met the inclusion criteria of the study, of which, 90 patients (83.33%) received medical therapy and 18 patients (16.67%) underwent surgery. The most expensive drugs were the prostaglandin analogues, travoprost (Travatan) and latanoprost (Xalatan). The least expensive topical drugs were beta-blockers and miotics. The mean annual cost of medical treatment was US$ 273.47±174.42 (range, 41.54to41.54 to 41.54to729.23) while the mean annual cost of surgical treatment was US$ 283.78±202.95 (range, 61.33to61.33 to 61.33to592.63). There was no ...