The spectrum of glaucoma presentation at Menelik II Hospital, Addis Ababa.

BACKGROUND

Glaucoma is a major cause of blindness in Africa. However, many do not know if they have the disease until late.

OBJECTIVE

The aim of this study was to describe the type and severity of glaucoma at presentation

METHODS

A hospital based prospective review of 602 glaucoma patients was conducted over 18 month period ending in 2009. A special registry captured Socio demographic and clinical data at the glaucoma clinic of Menelik II Hospital in Addis Ababa. The vertical cup disc ratio (CDR) of the optic nerve head provided the bases to stage, the severity of glaucoma.

RESULTS

Large portion of the total reviewed patients were men, 401 (66.6%) or above the age of 40 years, 484 (80.4%). The mean intraocular pressure was 28.5 and 30.6 in the right and left eye in mmHg. The leading subtypes of glaucoma, accounting 64.3% (n = 387), were Primary Open Angle Glaucoma, 227 (37.7%) and Pseudo exfoliation glaucoma, 160 (26.6%). At presentation, 260 (44%) and 109 (18%)) were unilaterally and bilaterally blind (vision < 3/60) respectively. Bilateral glaucoma was found in 464 (77%) and 366 (61%) presented with advanced stage (CDR > or = 9.0). Cases with advanced stage were likely to present with blindness [Odds Ratio (OR) -6.2 95% CI (3-8-10.1) and 6.9 95% CI (4.2-11.3)] or high Intraocular pressure >30mmHg [OR=3.4, 95% CI (2.2 -5.2) and 2.8, 95% CI (1.4-3.4)] in the respective right and left eyes. The stage, had no statistically significant association with age, sex, residence or type of glaucoma (Chi2 test, p > 0.05).

CONCLUSIONS

A large proportion of patients still arrive at glaucoma clinic with a very late stage of open angle glaucoma. Intervention strategies are requiredfor early detection and treatment of glaucoma in Ethiopia.