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Mona Khurana, R Ramakrishnan, Mohideen A Kader; Opportunistic Glaucoma Screening in Rural India: Role of Vision Centres. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1410.
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To study the role of Vision Centres in opportunistic screening for glaucoma in rural India.
A retrospective chart review of all patients attending 5 vision centres (under Aravind Eye Hospital, Tirunelveli) from a period of May 2007 to August 2010 was done. All patients had undergone a comprehensive eye examination by mid level ophthalmic practioners (MLOPs). Patients with any of the following: a family history of glaucoma, intraocular pressure > 21mmHg, shallow anterior chamber (Van Hericke ≤ 2), optic disc changes suggestive of glaucoma were referred to the base hospital for management. Data was analysed with respect to the diagnosis and response rate at the hospital.
Out of the total 82,349 patients examined, a provisional diagnosis of glaucoma was made in 852. 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. Both POAG and angle closure disease are prevalent in Indian population. Population based screening, however is not cost-effective. Vision centres were established under the vision 2020 program to improve utilization of services in rural areas. They provide permanent primary eye care, are affordable and easily accessible to the rural population. By conducting glaucoma screening during a patients’ regular visit to a Vision Centre, a large section of the rural population at risk of glaucoma can be reached. In our study a provisional diagnosis of glaucoma was made in 1.04% patients visiting the vision centre and confirmed in 90% of patients who visited the base hospital. In the presence of limited economic resources Vision Centres can be used for opportunistic glaucoma screening in rural population which would otherwise be difficult to access and help reduce the burden of disease.
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