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Mona Khurana, MOHIDEEN KADER, Rengappa Ramakrishnan; Opportunistic Glaucoma Screening in Rural India: Role of Vision Centers. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4407.
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To study the role of Vision Center in opportunistic screening for glaucoma in rural India.
We reviewed the charts of all patients attending 5 vision centers (under Aravind Eye Hospital, Tirunelveli) from a period of May 2007 to August 2010. All patients had undergone a comprehensive eye examination by mid level ophthalmic practitioners (MLOPs) and those with any of the following: a family history of glaucoma, intraocular pressure =/> 21mmHg, shallow anterior chamber, optic disc changes suggestive of glaucoma were referred to the base hospital. Data were analyzed with respect to the diagnosis and response rate at the hospital.
Of the total 82,349 patients examined, 852 (1.04%) had a provisional diagnosis of glaucoma. Of these, 20.4% had Primary open angle glaucoma (POAG), 26.04% were POAG suspects, 18.7% had angle closure disease and 19.94 % had secondary glaucoma. 75% of referred patients visited the base hospital. Diagnosis of glaucoma/ glaucoma suspects was confirmed in 90% of patients who visited the base hospital.
Glaucoma being a silent disease, the importance of screening cannot be undermined. However, population based screening is not cost-effective. Both POAG and angle closure disease are prevalent in India, where most of the population resides in the rural areas. Vision centers, established under the Vision 2020 program to improve utilization of services in rural areas provide permanent primary eye care, are affordable and easily accessible. By screening for glaucoma during a patients’ regular visit to a Vision Center, a large section of the rural population at risk of glaucoma can be accessed. In our study, a provisional diagnosis of glaucoma was made in 1.04% patients visiting the vision center and confirmed in 90% of patients who visited the base hospital. In the presence of limited economic resources, Vision centers can be used for opportunistic glaucoma screening in rural population which would otherwise be difficult to access and help reduce the burden of disease. Further studies are needed to evaluate and explore their full potential in detection of disease.
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