Blindness Profile in Glaucoma patients in a Tertiary Eye-care Hospital in India

Abstract

Purpose: : To evaluate the blindness profile in glaucoma patients by assessing the clinical profile of the patient, questionnaire on general information and treatment of glaucoma and the socioeconomic status of the patient.

Methods: : A case-control study (60patients, 30 patients in each group) conducted at a tertiary eye-care centre (Dr Rajendra Prasad Centre for Ophthalmic Sciences), New Delhi, India. Inclusion criteria consisted of glaucoma patients belonging to POAG, PACG, NTG group whose vision loss was attributed to glaucoma exclusively, excluding all other patients whose vision loss could be associated with other pathological process in the eye i.e, ARMD, CRVO. The Case group included glaucoma patient who were having vision of ≤10/200 or equivalent on Snellen chart in better eye and/or visual field constriction to central 20 degree on its widest diameter to Goldmann III4e test object and the Control group included glaucoma patient who had vision of >20/200 or equivalent on Snellen chart in better eye. All patients underwent a comprehensive ocular examination including gonioscopy, perimetry and detailed family and social history (education and socioeconomic status). A questionnaire on general information and treatment on glaucoma were also filled by all patients. SPSS version 15.0 was used, and univariate and multivariate logistic regression analysis was used.

Results: : Gradual progressive painless diminution of vision was the most common presenting symptom (47/60; 78.3%). Age range was comparable in both the groups. Mean age of presentation in the cases and control groups - 60.63yrs Vs 63.57yrs, Male : Female ratio = 2.3:1 Vs 4:1. Blindness was more common in patients of Primary angle closure glaucoma (p<0.001; odds ratio = 7.5; 95% CI = 2.24-25.06 ) and lower socioeconomic groups (p<0.001; odds ratio = 8.5; 95% CI = 2.37-30.46 ). Blind patients were less educated and the awareness about glaucoma was poor in the cases than controls (p=0.000).

Conclusions: : Lack of education and awareness of glaucoma and lower socioeconomic status were the major risk factors for blindness in glaucoma.

Keywords: clinical (human) or epidemiologic studies: risk factor assessment