Pattern of presentation of primary open-angle glaucoma in Benin City, Nigeria.

Late presentation is a major problem in the management of patients with primary open-angle glaucoma. The aim of this study was to determine the clinical features and the degree of visual disability of glaucoma patients at initial presentation. This was a prospective study of new patients with a diagnosis of primary open-angle glaucoma seen between January 2001 and August 2002 at the University of Benin Teaching Hospital, Nigeria. The patients were analysed in the context of age, gender, geographical abode, educational and socioeconomic status and clinical presentation. The patients were examined using the Snellen's chart, pen torch, slit lamp biomicroscopy, ophthalmoscopy, tonometry, perimetry and gonioscopy. Over a 20-month period 154 patients were studied; the mean age was 52.73 years (standard deviation +/- 15.98) and the highest incidence was in the seventh decade. The male to female ratio was 2.1:1. In all, 119 patients (77.3%) presented with subjective visual loss in one or both eyes, while 57.1% dated the onset of their symptoms to 1-5 years before presentation. Overall, 38 patients (24.7%) were blind when using visual acuity as the criteria, while 87 patients (56.5%) were blind when using visual fields as the criteria. The problem of late presentation has not improved over the last two and a half decades. More measures towards early detection by extensive health education, screening programmes and training of more eye care providers need to be put in place.