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      Prevalence and distribution of glaucoma in central India (Glaucoma Survey - 2001)

      other
      , MS, , MS , , MS, DCEH
      Indian Journal of Ophthalmology
      Medknow Publications
      Blindness, glaucoma, India, low vision, prevalence study

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          Abstract

          Purpose:

          A community-based survey was conducted in Rajnandangaon district of Chhattisgarh state of central India in 2001 to assess the prevalence of glaucoma in the age group of ≥35 years.

          Design:

          Community-based cross-sectional survey

          Materials and Methods:

          Ophthalmologists measured ocular pressure using Perkins applanation tonometer. Best corrected visual acuity was checked by ETDRS chart. After dilating the pupil the fundus was examined. A sketch diagram was drawn to note glaucomatous changes in optic disc and the surrounding retina. The field of vision was tested on Bjerrum screen. Gonioscopy was performed to determine type of glaucoma. Persons and their relatives were interviewed to find out risk factors and glaucoma treatment in the past.

          Results:

          Seven thousand four hundred and thirty-eight (87.3%) persons were examined. The age-sex standardized prevalence of glaucoma was 3.68% (95% CI 3.27 to 4.07). Gender variation of glaucoma was not significant. [OR = 1.13 (CI 95% 0.88 to 1.44)] Glaucoma varied significantly by age groups. (Χ 2 = 48.2, degree of freedom = 3 P <0.001) Among those patients diagnosed to suffer from glaucoma, the proportion of open angle, closed angle, secondary glaucoma, ocular hypertension and glaucoma suspects was 13.1%, 21.2%, 21.2%, 14.5% and 30% respectively. Different types of visual disabilities were associated with glaucoma. However, unilateral blindness in glaucoma was unusual. Twenty-five per cent of the glaucoma cases were detected for the first time during the survey.

          Conclusions:

          The prevalence of glaucoma was high and the angle closure type was more compared to the open angle glaucoma.

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          Most cited references31

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          Prevalence of open-angle glaucoma in Australia. The Blue Mountains Eye Study.

          The purpose of this study was to determine the prevalence of open-angle glaucoma and ocular hypertension in an Australian community whose residents are 49 years of age or older. There were 3654 persons, representing 82.4% of permanent residents from an area west of Sydney, Australia, who were examined. The population was identified by a door-to-door census of all dwellings and by closely matched findings from the national census. All participants received a detailed eye examination, including applanation tonometry, suprathreshold automated perimetry (Humphrey 76-point test), and Zeiss stereoscopic optic disc photography. Glaucoma suspects were asked to return for full threshold fields (Humphrey 30-2 test), gonioscopy, and repeat tonometry. A 5-point hemifield difference on the 76-point test was found in 616 persons (19% of people tested). Humphrey 30-2 tests were performed on 336 glaucoma suspects (9.2% of population), of whom 125 had typical glaucomatous field defects. Two hundred three persons had enlarged or asymmetric cup-disc ratios (> or = 0.7 in 1 or both eyes or a cup-disc ratio difference of > or = 0.3). Open-angle glaucoma was diagnosed when glaucomatous defects on the 30-2 test matched the optic disc changes, without regard to the intraocular pressure level. This congruence was found in 87 participants (2.4%), whereas an additional 21 persons (0.6%) had clinical signs of open-angle glaucoma but incomplete examination findings. Open-angle glaucoma was thus found in 108 persons, a prevalence of 3.0% (95% confidence interval [CI], 2.5-3.6), of whom 49% were diagnosed previously. An exponential rise in prevalence was observed with increasing age. Ocular hypertension, defined as an intraocular pressure in either eye greater than 21 mmHg, without matching disc and field changes, was present in 3.7% of this population (95% CI, 3.1-4.3), but there was no significant age-related increase in prevalence. The prevalence of glaucoma was higher in women after adjusting for age (odds ratio, 1.5; CI, 1.0-2.2). There was no sex difference in the age-adjusted prevalence of ocular hypertension. These data provide detailed age and sex-specific prevalence rates for open-angle glaucoma and ocular hypertension in an older Australian population.
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            The prevalence of glaucoma in a population-based study of Hispanic subjects: Proyecto VER.

            To determine the prevalence of glaucoma in a population-based sample of Hispanic adults older than 40 years. Using 1990 census data for Arizona, groups of persons living in sections of the city in Nogales and Tucson were randomly selected with a probability proportional to the Hispanic population older than 40 years. We tried to recruit all eligible adults in homes with 1 self-described Hispanic adult. Detailed ocular examinations at a local clinic included visual acuity testing, applanation tonometry, gonioscopy, an optic disc evaluation, and a threshold visual field test. Open-angle glaucoma (OAG) was defined using a proposed international system for prevalence surveys, including threshold visual field defect and optic disc damage. Angle-closure glaucoma was defined as bilateral appositional angle closure, combined with optic nerve damage (judged by field and disc as for OAG). Examinations were conducted in 72% (4774/6658) of eligible persons, with a 1.97% prevalence (95% confidence interval, 1.58%-2.36%) of OAG (94 persons). The age-specific OAG prevalence increased nonlinearly from 0.50% in those aged 41 to 49 years to 12.63% in those 80 years and older. Angle-closure glaucoma was detected in 5 persons (0.10%). Sex, blood pressure, and cigarette smoking were not significant OAG risk factors. Only 36 (38%) of the 94 persons with OAG were aware of their OAG before the study. Screening results with an intraocular pressure higher than 22 mm Hg (in the eye with a higher pressure) would miss 80% of the OAG cases. The prevalence of OAG in Hispanic persons was intermediate between reported values for white and black persons. The prevalence increased more quickly with increasing age than in other ethnic groups. Glaucoma was the leading cause of bilateral blindness.
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              Prevalence of open-angle glaucoma and ocular hypertension in Latinos: the Los Angeles Latino Eye Study.

              To estimate age- and gender-specific prevalences of ocular hypertension and open-angle glaucoma (OAG) in adult Latinos. Population-based, cross-sectional study. Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California. The study cohort consisted of all self-identified Latinos of primarily Mexican ancestry 40 years and older residing in 6 census tracts in La Puente, California. All participants underwent a complete ophthalmologic examination, including measurement of intraocular pressure (IOP), visual field (VF) testing using an automated field analyzer, and simultaneous stereoscopic fundus photography of the optic disc. Ocular hypertension was defined as IOP of >21 mmHg and the absence of optic disc damage or abnormal VF test results. Open-angle glaucoma was defined as the presence of an open angle and various criteria that included a glaucomatous VF abnormality and/or evidence of glaucomatous optic disc damage in at least one eye. Prevalence of open-angle glaucoma and ocular hypertension. For the 6142 participants who underwent a complete ophthalmologic examination at the clinical center, the prevalence of OAG was 4.74% (95% confidence interval [CI], 4.22%-5.30%). The prevalence of ocular hypertension was 3.56% (95% CI, 3.12%-4.06%). The prevalences of OAG and ocular hypertension were higher in older Latinos than in younger Latinos (P<0.0001). No gender-related differences in prevalences of OAG and ocular hypertension were present. The mean IOP, mean deviation, and mean vertical cup-disc ratio in persons with OAG were 17 mmHg, -9.6 decibels, and 0.6, respectively. Seventy-five percent of Latinos with OAG and 75% of Latinos with ocular hypertension were previously undiagnosed. Further, 17% of Latinos with OAG and 23% of Latinos with ocular hypertension had received treatment for "glaucoma." Our data suggest that the prevalence of OAG is high among Latinos of Mexican ancestry. The higher prevalence of OAG in older Latinos emphasizes the public health importance of providing eye care services for the early diagnosis and management of this condition in Latinos.
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                Author and article information

                Journal
                Indian J Ophthalmol
                Indian Journal of Ophthalmology
                Indian Journal of Ophthalmology
                Medknow Publications (India )
                0301-4738
                1998-3689
                Jan-Feb 2008
                : 56
                : 1
                : 57-62
                Affiliations
                H V Desai Eye Hospital, Pune, India (AP); Eye and Ear Health Care, NCD, DGHA, Ministry of Health, Oman (RK); Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashatra, India (VV).
                Author notes
                Correspondence to Dr. Rajiv Khandekar, Eye and Ear Health Care, NCD, DGHA, MOH (HQ), POB: 393, Pin: 113, Muscat, Oman. Email: rajshpp@ 123456omantel.net.om
                Article
                IndianJOphthalmol_2008_56_1_57_37597
                10.4103/0301-4738.37597
                2636061
                18158405
                103b9f3e-911a-437e-b723-efa49e91645c
                Copyright: © Indian Journal of Ophthalmology

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 March 2006
                : 27 February 2007
                Categories
                Community Eye Care

                Ophthalmology & Optometry
                prevalence study,glaucoma,india,blindness,low vision
                Ophthalmology & Optometry
                prevalence study, glaucoma, india, blindness, low vision

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