Early detection of primary angle-closure glaucoma. Limbal and axial chamber depth screening in a high risk population (Greenland Eskimos)

Abstract

In an unselected population of 541 Greenland Eskimos, a survey was performed aiming at early primary angle-closure glaucoma (PACG) detection. Of the men 162/274 and women 182/267 were above the age of 40. The ophthalmological examination included slit-lamp grading of limbal chamber depth (LCD), axial Haag Streit pachymetric chamber depth (ACD) measurement and direct gonioscopy in all shallow chamber cases. Dark room prone position provocative tests were extensively used in suspects. In 3 men and 5 women PACG was diagnosed, giving, above age 40, a prevalence of 2% in men (3/162) and increasing the PACG prevalence to 10% in women (18/182) as 13 were known a priori. PACG suspects, needing prophylactical iridectomy or pilocarpine, constituted 1 man and 6 women. Furthermore, narrow angles were found in 14 men and 27 women above age 40, and so far untreated. On the present background of highly effective surgical and YAG-laser iridectomy facilities in early PACG, local, other arctic and global prevention of blindness aspects are briefly discussed, with a special outlook to SE-Asia.