Cook Colin
Department of Ophthalmology, Groote Schuur Hospital, Cape Town, South Africa.
J Glaucoma. 2009 Feb;18(2):124-8. doi: 10.1097/IJG.0b013e318189158c.
To obtain an estimate of the magnitude of the problem of glaucoma in sub-Saharan Africa, and to evaluate the existing evidence for including glaucoma as a priority disease in our Vision 2020 programs in Africa.
A Pubmed search was carried out using "glaucoma prevalence Africa," "glaucoma presentation Africa," "glaucoma blindness Africa," "glaucoma screening Africa," and "glaucoma treatment Africa" as key words.
Most glaucoma in Africa is primary chronic open angle glaucoma, it may occur at an earlier age, it may be associated with a higher intraocular pressure, it may be more rapidly progressive, and it may present late. The prevalence of glaucoma in East, Central, and Southern Africa can be conservatively estimated to be 10,000 people for every 1 million population. This prevalence may be higher in West Africa. The annual incidence of glaucoma can be conservatively estimated to be 400 new cases for every 1 million population. Glaucoma is the second leading cause of blindness after cataract, responsible for up to 30% of blindness. Case detection of glaucoma could be carried out at both the primary and secondary level. Primary trabeculectomy with mitomycin C or beta irradiation adjunct may be a suitable treatment. Cases could be followed up after surgery by mid-level eye care workers, using the intraocular pressure as the indicator for adequacy of control, and using a glaucoma register to identify and trace defaulters.
Glaucoma should be included as a priority disease in Vision 2020 programs in Africa.
评估撒哈拉以南非洲地区青光眼问题的严重程度，并评估将青光眼列为非洲“视觉2020”计划重点疾病的现有证据。
以“非洲青光眼患病率”“非洲青光眼临床表现”“非洲青光眼致盲情况”“非洲青光眼筛查”及“非洲青光眼治疗”为关键词，在PubMed数据库进行检索。
非洲的大多数青光眼为原发性慢性开角型青光眼，发病年龄可能更早，眼压可能更高，病情进展可能更快，且就诊时往往较晚。东非、中非和南非青光眼的患病率保守估计为每百万人口中有10000人患病。西非的患病率可能更高。青光眼的年发病率保守估计为每百万人口中有400例新发病例。青光眼是仅次于白内障的第二大致盲原因，导致高达30%的失明。青光眼的病例检测可在初级和二级层面开展。采用丝裂霉素C或β射线辅助的原发性小梁切除术可能是一种合适的治疗方法。术后可由中级眼科医护人员进行随访，以眼压作为控制是否充分的指标，并使用青光眼登记册来识别和追踪失访患者。
青光眼应被列为非洲“视觉2020”计划的重点疾病。
