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Donald L. Budenz, Joyce Schiffman, Jagadeesh Bandi, Tema Eye Survey Study Group; Prevalence of Glaucoma in an Urban West African Population: The Tema Eye Survey. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5320.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the prevalence of glaucoma in an urban West Africa population.
A random cluster sampling of adults age 40 and over was conducted in the city of Tema, Ghana, West Africa. Subjects underwent a field examination near their home consisting of visual acuity, frequency doubling perimetry, Tonopen intraocular pressure, and optic disc photography. Subjects who failed any of these tests were referred for compete examination by a study ophthalmologist with gonioscopy, standard white-on-white perimetry, and stereoscopic optic disc photographs. Masked readers assessed all optic disc photographs and visual fields. The definition of glaucoma by Foster and associates1 was used and the type of glaucoma was determined by study investigators who examined subjects.
6806 eligible subjects were identified of which 5603 (82.3%) participated in the study. 60.3 % of the participants were female and 39.7 % were male. The average age of participants (mean ±standard deviation) was 52.72±10.89. The field examination identified 1869 (33.3%) subjects who failed one or more screening examinations. Of these, 1538 came back to the clinic for complete examination by an ophthalmologist for a participation rate at this stage of 82.2%. The prevalence of category 1 glaucoma (definite glaucomatous optic disc and visual field abnormality) was 353 out of 5603 or 6.3%. The prevalence of category 2 glaucoma (advanced optic disc damage with unproven visual field loss) was 39 out of 5603 or 0.7%. The prevalence of category 3 glaucoma (IOP ≥ 35 mmHg and VA < 20/400 with optic disc not seen and visual field test impossible or visual acuity < 20/400 and evidence of previous glaucoma filtering surgery or medical record confirmation of glaucomatous visual morbidity) was 8/5603 or 0.14%. Combining all 3 categories, the prevalence of glaucoma in this population was 400 out of 5603 or 7.1%. Of the 400 subjects identified with glaucoma, 367 (91.8%) were examined by an ophthalmologist. Primary open angle glaucoma was the underlying diagnosis in 96.8% of subjects and chronic narrow angle glaucoma in the remaining 3.2%.
Glaucoma is extremely prevalent in urban West Africa. Strategies to identify affected patients and effectively manage the disease are needed.
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