Glaucoma in developing countries

Thomas, Ravi (2012) Glaucoma in developing countries. Indian Journal of Ophthalmology, 60 5: 446-450. doi:10.4103/0301-4738.100546

Author Thomas, Ravi
Title Glaucoma in developing countries
Journal name Indian Journal of Ophthalmology   Check publisher's open access policy
ISSN 0301-4738
Publication date 2012-09
Sub-type Article (original research)
DOI 10.4103/0301-4738.100546
Open Access Status DOI
Volume 60
Issue 5
Start page 446
End page 450
Total pages 5
Place of publication Mumbai, Maharastra, India
Publisher Medknow Publications and Media
Collection year 2013
Language eng
Formatted abstract
Objective: To describe the background and strategy required for the prevention of blindness from glaucoma in developing countries.

Materials and Methods: Extrapolation of existing data and experience in eye care delivery and teaching models in an unequally developed country (India) are used to make recommendations.

Results: Parameters like population attributable risk percentage indicate that glaucoma is a public health problem but lack of simple diagnostic techniques and therapeutic interventions are barriers to any effective plan. Case detection rather than population-based screening is the recommended strategy for detection. Population awareness of the disease is low and most patients attending eye clinics do not receive a routine comprehensive eye examination that is required to detect glaucoma (and other potentially blinding eye diseases). Such a routine is not taught or practiced by the majority of training institutions either. Angle closure can be detected clinically and relatively simple interventions (including well performed cataract surgery) can prevent blindness from this condition. The strategy for open angle glaucoma should focus on those with established functional loss. Outcomes of this proposed strategy are not yet available.

Conclusions: Glaucoma cannot be managed in isolation. The objective should be to detect and manage all potential causes of blindness and prevention of blindness from glaucoma should be integrated into existing programs. The original pyramidal model of eye care delivery incorporates this principle and provides an initial starting point. The routine of comprehensive eye examination in every clinic and its teaching (and use) in residency programs is mandatory for the detection and management of potentially preventable blinding pathology from any cause, including glaucoma. Programs for detection of glaucoma should not be initiated unless adequate facilities for diagnosis and surgical intervention are in place and their monitoring requires reporting of functional outcomes rather than number of operations performed.
Keyword Case detection
Comprehensive eye examination
Developing countries
Integrated approach
Training requirements
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
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