Glaucoma in a rural population of southern India

British Journal of Ophthalmology, 2005

To determine (i) the prevalence of glaucoma in people aged >50 years, (ii) the proportions of different types of glaucoma, (iii) the distributions of intraocular pressure and vertical cup disc ratio. Method: Population based prevalence survey in rural West Bengal. People aged >50 years in randomly selected villages in 24 Parganas South district. The main outcome measures were diagnosis of glaucoma, based on criteria described by the International Society for Geographic and Epidemiological Ophthalmology. Results: 1594 people aged >50 years were enumerated in nine villages; 1324 (83.1%) were surveyed and 1269 people adequately examined. 42 definite cases of glaucoma were identified, with prevalence increasing from 2.7% (95% CI 1.7 to 3.7) in people aged 50-59 years to 6.5% (95% CI 0.0 to 14.1) in those aged >80 years. The age standardised estimate for the prevalence of all glaucoma in people aged >50 years was 3.4%. Only three cases of primary angle closure glaucoma (PACG) were identified, giving a crude ratio of primary open angle glaucoma (POAG) to PACG of more than 10:1. Three people with glaucoma were blind in one eye but none was blind in both eyes. Conclusion: Compared to other surveys of glaucoma in India, the age standardised prevalence observed was less than in Hyderabad, but similar to Tamil Nadu and Dhaka. The ratio of POAG to PACG was much higher than found previously, suggesting that PACG may be less prevalent in Bengalis than in Indian populations living in south India. The authors conclude that ophthalmic services in West Bengal should focus on detecting POAG. Since there is still no satisfactory method of screening for POAG, there is no alternative to case detection (opportunistic screening) in eye clinics.

Innovative Publication, 2017

Introduction: Primary Open Angle Glaucoma causes damage to the fibers of optic nerve which results in permanent visual loss. There may not be any symptoms; this is dangerous because patient may become blind silently. Glaucoma caused by angle closure mechanism causes symptoms and patient seeks medical attendance early. Aims and Objectives: To study clinical types and Factors associated with the Glaucoma patients. Methodology: This was cross-sectional study of the patients reporting to ophthalmology outpatient department or admitted in the ophthalmology wards having symptoms suggestive of Glaucoma, at tertiary health care center during the year 2016. The patients underwent detailed elucidation of history and examination. All essential investigations were undertaken. Attention was also paid to monitor treatment response and follow up. As per above criteria total 64 patients were included into the study. Result: Majority of the Glaucoma patients were from older age group. As age increases the problem of Glaucoma was more prevalent. It was more frequent in Males. More patients had Open angle Glaucoma than close angle or narrow angle. The most common associated factors with Glaucoma patients were Diabetes followed by Systemic Hypertension; Phacomorphic; post Iridocyclitis; Steroid induced Glaucoma; Traumatic Glaucoma. Conclusion: The problem of Glaucoma was more common in Older age and in males. The most common associated factors with Glaucoma patients were Diabetes followed by Systemic Hypertension; Phacomorphic; post Iridocyclitis; Steroid induced Glaucoma; Traumatic Glaucoma. So these factors should be considered during diagnosis and management of Glaucoma patients.

IOSR Journals , 2019

Introduction: Visual impairment is a global public health problem and glaucoma is the leading cause of irreversible blindness worldwide.Primary angle-closure glaucoma (PACG) and primary angle closure (PAC) are more common in East Asian countries than in Western countries, and the former often results in bilateral blindness. in the Department of Ophthalmology. The study was a descriptive observational study. Written informed consent procedure was followed in all patients recruited into the study.The study group consisted of 950 patients aged 40 years and above, belonging to both sexes; these patients presented themselves for their geriatric ocular problems like Presbyopia, Refractive errors, Diminution of vision, Diabetes, Hypertension, Migraine, Cardiovascular disorders as referred from the department of Medicine for Ophthalmic evaluation. Results: Out of 950 patients screened, open angle glaucoma was noted in 50 cases. This shows the prevalence of open angle glaucoma as 5%. Out of which, 33 were diagnosed to have primary open angle glaucoma(POAG), 13 were normal tension glaucoma(NTG) and 4 had ocular hypertension. There was a steady increase in the number of cases of glaucoma as age advances in those who show an ocular tension of 21 mmHg and above. Average IOP for both sexes in 50 cases of open angle Glaucoma is 23.22 mmHg. Thirty-one patients with POAG and NTG had early field defects. 25 patients showed established field defects and 30 patients showed advanced field defects at least in one eye. Advanced field defects were seen with an increase in CDR of 0.7 and above in 30 patients. A positive family history of open angle glaucoma was elicited in 15 cases of POAG in the first-degree relatives. Conclusion: The prevalence of open angle glaucoma in this hospital-based study was 5%. Age, elevated intra-ocular tension, large cup/disc ratio, asymmetric cupping, myopia, disc haemorrhage, diabetes and positive family history are proven as risk factors in the current study. Elevated IOP is the most important risk factor for the development of glaucoma.

IOSR Journals , 2019

Glaucoma is the second most prevalent cause of vision loss worldwide. Prevalence is expected to rise from 60 million people worldwide in 2010 to 80million in 2020. Research has shown that the prevalence of glaucoma varies according to both geographical region & race. Aim: The present study was undertaken to find out the prevalence of glaucoma and its subtypes in a hospital based population in Kashmir valley. Materials and methods: A prospective, observational study of all the patients referred to the glaucoma clinic of the post graduate deptt. of ophthalmology, GMC, Srinagar was undertaken for a period of one year between June 2011-2012. All the patients underwent a comprehensive ocular examination which included:Demographic data ,Detailed history and Comprehensive ocular examination. Slit-lamp was the backbone of our examination. Observations: A total of 40,012 patients attending the ophthalmology OPD of our hospital were screened for glaucoma from june2011 to june2012 out of which 1600 patients were found to have glaucoma , giving an overall prevalence rate of glaucoma as 4% in hospital population. Mean age of patients was 56.8 years at presentation with 86.5% of patients were above 40 years of age.. 67.5% patients were males and rest were females with male: female ratio of 9 : 4 (Fig.2). About two-third (66%) of the patients were from rural areas and 66.5% of the patients were doing unskilled work. 71.4 % patients presented with the decreased visual acuity of <6/18 in at least one eye. About 17.7 % of patients had a visual acuity of PL-ive in at least one eye at presentation. 70% of patients had bilateral and 30% had unilateral involvement. Perimetry showed moderate to advanced field loss in 80% cases. 39.2 % had PEX glaucoma, the commonest glaucoma in our study. 31.1% had PAOG, 7.8 % had angle closure glaucoma.Among other types of glaucoma's NVG constituted 1.6% , steroid induced glaucoma 2.25%,congenital glaucoma 1.5%,traumatic glaucoma 1.25%,JOAG & phacomorphic constituted 1% each, and NTG 0.6% of all the glaucoma's.The ratio of PAOG to PACG was 3.96:1 Conclusion: PEX glaucoma is a rapidly progressing and sight-threatening disease and most common type of glaucoma in our valley, so ophthalmic services in Kashmir valley should focus on detecting PEX glaucoma.

Investigative Opthalmology &amp; Visual Science, 2013

To determine the prevalence and types of glaucoma in an urban Singaporean Indian population. METHODS. The Singapore Indian Eye Study (SINDI) was a population-based, cross-sectional survey that examined 3400 (75.6% response) persons aged 40 to 80 years. Participants underwent a standardized examination including slit-lamp biomicroscopy, Goldmann applanation tonometry, and dilated optic disc assessment. Participants suspected to have glaucoma also underwent visual field examination (24-2 SITA standard, Humphrey Visual Field Analyzer II), gonioscopy, and repeat applanation tonometry. Glaucoma was defined according to International Society for Geographical and Epidemiologic Ophthalmology criteria. Of the 3400 participants, 78 (2.29%) had diagnosed glaucoma, giving an agestandardized prevalence of 1.95% (95% confidence interval [CI], 1.5%-2.5%). The agestandardized prevalence of primary open-angle glaucoma (POAG) was 1.25% (95% CI, 0.89%-1.73%), primary angle-closure glaucoma (PACG) 0.12% (95% CI, 0.04%-0.33%), and secondary glaucoma 0.55% (95% CI, 0.35%-0.86%). The mean IOP among the participants in the normal group in the study population was 15.6 6 2.6 mm Hg and 17.7 6 6.1 mm Hg in subjects with glaucoma (P ¼ 0.003). The mean central corneal thickness (CCT) in the normal study population was 540.31 6 33.79; the mean CCT in subjects with POAG (529.8 6 30.8 lm) was statistically different from the normal study group (P ¼ 0.003). CONCLUSIONS. The prevalence of glaucoma among Singaporean Indians 40 years of age and older in Singapore was 1.95%, approximately half that of the Chinese and the Malay persons in Singapore. As in other Asian studies, POAG was the main form of glaucoma accounting for nearly 60% of cases.

Journal of Evolution of medical and Dental Sciences, 2015

BACKGROUND: To study the profile of glaucoma in patients ≥35 years of age attending eye Out Patient Department in a tertiary care center of Kumaon region in Uttarakhand. METHODS: A cross sectional study was conducted in Out Patient Department of Ophthalmology from November 2012 to October 2014. Total 200 patients were included in this study based on inclusion and exclusion criteria’s. RESULTS: Among 200 patients, profile of primary glaucoma identified included primary angle closure glaucoma 84(42%), primary open angle glaucoma 63(32%), glaucoma suspect 32(16%) and normal tension glaucoma 21(10%). Among subtypes of angle closure glaucoma, spectrum was primary angle closure suspect 9(10.71%), primary angle closure 15(17.86%) and primary angle closure glaucoma 60(71.43%). Male patients were 106(53%) and female patients were 94(47%). CONCLUSION: Primary angle closure glaucoma was observed most commonly followed by primary open angle glaucoma. Glaucoma was significantly associated with i...

Innovative Publication, 2016

Glaucoma is a group of disorders characterized by chronic progressive optic neuropathy resulting in irreversible visual loss. It is a second leading cause of blindness worldwide while it is third leading cause of blindness in India. The present study was carried out to study the prevalence of different types of glaucoma in rural population. In all cases, detailed clinical history and family history was taken. A thorough ophthalmic examination was carried out which includes visual acuity with snellen's chart, slit lamp examination, optic disc evaluation by slit lamp biomicroscopy and direct ophthalmoscopy, angle evaluation by gonioscopy, intraocular pressure (IOP) recording by Applanation tonometry, visual field analysis by Humphrey visual field analyser(24-2) and general medical examination. A total of 17792 patients were examined of which 133 (0.74%) of various type of glaucoma were diagnosed. It was noted that overall prevalence of primary open angle glaucoma was 0.26%, 0.06% for normal tension glaucoma, 0.06% for angle closure glaucoma and 0.03% for juvenile glaucoma. The prevalence of common type of secondary glaucoma was 0.15% for lens induced glaucoma, 0.06% for traumatic and 0.05% for aphakic glaucoma. We concluded that primary open angle glaucoma was more common with maximum number of cases in the age group of 56-75 years, average age being 61 years. High prevalence rate of glaucoma was due to poor health education, low socioeconomic status and inaccessibility of ophthalmologists specifically in rural and tribal areas.

PLOS ONE, 2013

Purpose: To assess the prevalence of glaucoma in rural Central India. Methods: The population-based Central India Eye and Medical Study is a population-based study performed in a rural region of Central India. The study included 4711 subjects (aged 30+ years). A detailed ophthalmic and medical examination was performed. Glaucoma was defined by glaucomatous optic disc morphology, and in a second step, by the criteria of the International Society of Geographical and Epidemiological Ophthalmology (ISGEO).

Journal of Evidence Based Medicine and Healthcare, 2015

To evaluate Glaucomatous Optic Neuropathy (GON) and blindness in narrow angle glaucoma patients. MATERIALS AND METHODS: This is a hospital based retrospective analysis primary angle closure glaucoma patients attending eye OPD between June 2013 to May 2014.The demographic data related to age, sex, IOP and type of glaucoma was analyzed. Primary angle closure glaucoma (PACG) was diagnosed and categorized into symptomatic and asymptomatic groups according to the history and clinical presentation. Disc damage likelihood scale (DDLS) was used to evaluate glaucomatous optic neuropathy. RESULTS AND CONCLUSION: Out of 96 cases of all primary glaucoma cases, narrow angle glaucoma was present in 54 patients. Out of 54 cases, 36(67%) were asymptomatic and 18(33%) were symptomatic. Moderate to severe glaucomatous optic neuropathy was found in 64% in asymptomatic group. There were 45% cases with unilateral blindness in asymptomatic group as compared to 19% in symptomatic narrow angle glaucoma group. CONCLUSION: Asymptomatic narrow angle glaucoma was more commonly found. Increasing age, female gender and high IOP were significantly associated with it. Blindness due to asymptomatic narrow angle glaucoma was double as compared to acutely presenting narrow angle glaucoma.

2008

Glaucoma is estimated to affect 60.5 million persons worldwide by the year 2010.1 The estimated prevalence of glaucoma for India is 11.9 million.2 These estimates have been derived from population based studies conducted worldwide. The availability of population based data from India is relatively recent as compared to Western countries. We present a summary of the findings from different population based studies in the country. These have been five populations based studies, three from the state of Tamil Nadu, one from Andhra Pradesh and one from Bengal (Table 1).2-6 Data from North India is unfortunately lacking. These studies have been carried out from 1993 to 2003. To our best knowledge at least one more population based study (from Central India) is underway. All these studies have used differing methodology and diagnostic criteria for glaucoma. To improve comparability the prevalence reported by different studies has been age standardized to the population of India (2001 censu...

Journal of Kathmandu Medical College, 2014

Background: Primary open-angle glaucoma (POAG) is the commonest cause of irreversible blindness. Most hospitals in Nepal are carrying out opportunistic glaucoma screening for those attending hospitals for any eye consultation. However, there are no reports detailing the visual damage at the time of diagnosis confi rming the early detection of cases.

Indian Journal of Clinical and Experimental Ophthalmology, 2016

Objective: To study the profile of glaucoma patients in Eastern UP. Method: Prospective cross sectional study includes 193 cases of age group (more than 30 years). Both male and female were included. Results: The total number of 193 cases was studied. Out of these 106 (54.9%) were male and 87 (45.07%) were female with a male female ratio was 1.21. Primary glaucoma was more common than secondary glaucoma. Among primary glaucoma, primary narrow angle glaucoma (44.4%) was more common followed by primary open angle glaucoma (36.2%). Mean age of POAG patients was (54.2±7.2 years), PNAG was (60.1±11.1 years), NTG was of (64.6±11.8 years), ocular hypertension was of (55±7.2 years) and secondary glaucoma was of (53.2±11.2 years). PNAG was more common in females and rest of glaucoma was common in male. Glaucoma, Profile, Visual impairment, Eastern U.P. Conclusion: Glaucoma causes progressive atrophy of the optic disc resulting in typical defects in the visual field. It can lead to total loss of vision if left untreated. The diagnosis glaucoma has to be made only after comprehensive eye examination and not only on one parameter. Regular follow up is must to access progression which is essential for glaucoma. Glaucoma awareness has to be created among peoples, for them to get examined at early stage to rule out presence of glaucoma. If glaucoma is found, appropriate management is provided to prevent visual function impairment or loss.

Healthline, Journal of Indian Association of Preventive and Social Medicine, 2022

Introduction : Glaucoma is the leading cause of irreversible visual loss in world and also in India. Because of the relatively asymptomatic initial phase of the disease, it is often detected by chance and is frequently associated with extensive and irreversible damage at the time of diagnosis. Objectives: To screen for Glaucoma among patients eligible as per inclusion criteria, to classify the glaucoma cases according to clinical presentation and to correlate the occurrence of glaucoma with different variables. Method: The present study was conducted at one of the tertiary care hospitals of Ahmedabad city during celebration of "World Glaucoma Week-2021". Total 1421 patients were offered opportunistic screening after oral informed consent during 6-12 March 2021, who attended the institute. After applying exclusion criteria, 945 were found eligible who underwent a comprehensive ophthalmic examination like visual acuity, intraocular pressure measurement, gonioscopy, optical disc and visual filed examinations were carried out as per standard protocols. Sociodemographic details, any relevant ophthalmic history pertaining to glaucoma and systemic illnesses were also assessed. The data were entered and analyzed in MS excel. Results: The incidence of newly diagnosed cases of glaucoma among opportunistic screened cohort was 36.71% (n=347). Of total newly diagnosed, the presentation as per clinical classification was as follows: Primary open angle glaucoma (POAG)-202 (58.21%), Primary angle closure glaucoma (PACG)-77 (22.19%), Primary angle closure suspect (PACS)-41 (11.82%), Ocular hypertension (OHT)-6 (1.73%), Normal tension glaucoma (NTG)-10 (2.88%), Secondary glaucoma-9 (7.09%) and Congenital glaucoma-2 (0.58%). In yield, 25 (19.68%) were ≤40 years and 36 (28.35%) had positive family history of glaucoma. Conclusion: Presence of stand-alone Diabetes and Hypertension or presence of both accompanying-all three conditions were found to be statistically significant determinant for occurrence of particular variety of Glaucoma. There was highly significant statistical association between cup-disc ratio level at the time of presentation and clinical variety of glaucoma.

Indian Journal of Ophthalmology, 2011

Despite new medical and surgical strategies to control intraocular pressure (IOP), blindness caused by glaucoma continues to increase, and glaucoma remains the second or the third most common cause of blindness in the world. [9,10] As glaucoma is a disease with few symptoms in initials stages, late presentation is common and, when visual field loss threatens central vision, is an important risk factor for blindness. [11,12] While there have been few studies demonstrating the association of late presentation of glaucoma with social factors from the UK, [13,14] there has been none from India where glaucoma is a significant cause of blindness. [7] Lack of awareness about glaucoma also contributes to its late presentation. In the Barbados Eye Study (BES), about half of the total number of persons with prevalent primary open angle glaucoma (POAG, 51%) were unaware of their diagnosis. [15] Some communities in developed countries like the UK too had lack of awareness. [16] The Andhra Pradesh Eye Disease Study (APEDS) showed that awareness of glaucoma was very limited in the rural areas of southern India. [17] To our knowledge no such study has been conducted in Maharashtra in western India. We undertook a case-control study to determine the association between social factors, awareness, and late presentation of glaucoma in a tertiary eye care center in Maharashtra, West India. Materials and Methods A hospital-based case-control study was conducted involving patients diagnosed with primary glaucoma for the first time at visit to a tertiary eye care center in Pune, Maharashtra, India. Newly diagnosed patients with primary glaucoma were selected. A complete ophthalmic examination was performed including best corrected visual acuity (BCVA), IOP measurement by applanation tonometer and fundus examination for the cup:disc ratio (C:D ratio), gonioscopy by Goldman's three-mirror goniolens, and visual field test by the Humphrey automated perimeter (30-2 glaucoma threshold). The Hodapp-Parrish-Anderson visual field grading scale was used for the field defects. Glaucoma was diagnosed if the C:D ratio was >0.5 or if there was a difference of >0.2 between the two eyes with corresponding field defects. POAG and primary angle closure glaucoma (PACG) were differentiated by gonioscopy. Patients were classified as early and late presenters using the following criteria: early presenters (controls) had visual field with no absolute scotoma within 20° of fixation or C:D ratio >0.5 and <0.8 or a difference of >0.2 between the two eyes. Late presenters (cases) had no perception of light or severe visual field loss affecting an area within 20° of fixation or a C:D ratio >0.8. Patients with secondary glaucoma, congenital and

2008

To determine the prevalence of primary angle-closure glaucoma (PACG), primary angle closure (PAC), and PAC suspect (PACS) in an urban population, and to compare prevalence and associated risk factors with a rural population.