Is glaucoma blindness a disease of deprivation and ignorance? A case-control study for late presentation of glaucoma in India
- PMID: 21157069
- PMCID: PMC3032239
- DOI: 10.4103/0301-4738.73720
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.
Conflict of interest statement
References
-
- Pascolini D, Mariotti SP, Pokharel GP, Pararajasegaram R, E’Talye D, Negrel AD, et al. 2002 global update of available data in visual impairment: A compilation of population based prevalence studies. Ophthalm Epidemiol. 2004;11:67–115. - PubMed
-
- Cook C. Glaucoma in Africa: Size of the problem and possible solutions. Glaucoma. 2009;18:124–8. - PubMed
-
- Congdon N. Reducing the visual burden of glaucoma in Asia: What we know and what we need to know. J Glaucoma. 2009;18:88–92. - PubMed
-
- Khandekar R, Jaffer MA, Al Raisi A, Zutshi R, Mahabaleshwar M, Shah R, et al. Oman Eye Study 2005: Prevalence and determinants of glaucoma. East Mediterr Health J. 2008;14:1349–59. - PubMed
-
- Dandona L, Dandona R, Srinivas M, Mandal P, John RK, McCarty CA, et al. Open-angle Glaucoma in an Urban Population in Southern India, The Andhra Pradesh Eye Disease Study. Ophthalmology. 2000;107:1702–9. - PubMed
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