Visual Disability among Juvenile onset Open Angle Glaucoma patients

Abstract

Purpose: Primary Juvenile onset Open angle glaucoma ( JOAG) unlike adult onset primary open angle glaucoma presents with high IOP and diffuse visual field loss , which if left untreated leads to severe visual disability. The study aimed to evaluate the extent of visual disability among JOAG patients presenting to a tertiary eye care facility in India.

Methods: Visual acuity and Visual field Records of 320 unrelated JOAG patients presenting to our Glaucoma facility from the year 2000 onwards were analysed. Low vision and blindness were categorized by the WHO criteria and percentage impairment was calculated and compared between the guidelines provided by the American Medical association (AMA) and the Ministry of Social Justice, India.

Results: 18 (5.6%) out of the 320 JOAG patients were blind at presentation. 32 out of 320 (10%) patients had a visual impairment of 75% or more taking into account both their visual fields and their visual acuity as per AMA criteria. According to the Indian Standards for visual disability certification , a 75% or greater visual disability at presentation was seen in 35 out of 320 (10.9%). 76 (24%) patients were blind in one eye at presentation.

Conclusions: Visual disability was found to be very high among JOAG patients presenting to our tertiary eye care facility which emphasizes the need for early diagnosis especially screening family members to prevent a lifetime of disability and the economic costs thus incurred.