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Husain KA, Alaali H, Alarayedh GG. Prevalence and Characteristics of Glaucoma Among Patients Presenting to Ophthalmology Clinics in a Tertiary Hospital in the Kingdom of Bahrain. Cureus 2024; 16:e54129. [PMID: 38487113 PMCID: PMC10939155 DOI: 10.7759/cureus.54129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/17/2024] Open
Abstract
Introduction The aim of this study was to determine the prevalence and characteristics of glaucoma in patients presenting to the ophthalmology department in a tertiary hospital in Bahrain for the first time. Methods A retrospective study was conducted at the Salmaniya Medical Complex, Manama, Bahrain. The medical records of all patients who presented for the first time to an eye clinic between January and December 2019 were reviewed. Patients who were diagnosed with glaucoma were included in this study. Data regarding age, sex, ethnicity, type of glaucoma, previous treatment, best corrected visual acuity, cup-to-disc ratio, intraocular pressure, central corneal thickness, optical coherence tomography (OCT) retinal nerve fiber layer (RNFL), and visual field findings were collected. Results Of a total of 18,238 new patients in 2019, 173 patients (0.97%) had glaucoma. The mean age of patients with glaucoma was 59.6 ± 11.3 years and approximately 60% of them were males (n=103, 59.5%). In 93% of the cases, glaucoma involved both eyes (n=161). Primary open-angle glaucoma (n=97, 56.1%), normal tension glaucoma (n=28, 16.2%), and chronic angle closure glaucoma (n=15, 8.7%) were the most frequently encountered types of glaucoma. Approximately 16.76% (n=29) of the patients were blind in one or two eyes at the time of presentation. Conclusion There seems to be a low prevalence of glaucoma among the encountered cases on the first visit to ophthalmology clinics in Bahrain, with primary open-angle glaucoma being the most common type.
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Affiliation(s)
- Khatoon A Husain
- Ophthalmology Department, Salmaniya Medical Complex, Manama, BHR
| | - Haneen Alaali
- Ophthalmology Department, Salmaniya Medical Complex, Manama, BHR
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2
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Al-Timimi Z, Huang-Lung J, Keay L, Healey P, Yang E, Dunn H. A Systematic Review of Glaucoma Diagnosis in Prevalence Studies and Quality of Reporting. J Glaucoma 2023; 32:874-884. [PMID: 37406297 DOI: 10.1097/ijg.0000000000002248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/19/2023] [Indexed: 07/07/2023]
Abstract
PRCIS This systematic review has revealed that variable definitions of glaucoma continue to be used in prevalence studies, despite the introduction of the International Society of Geographic and Epidemiologic Ophthalmology (ISGEO) criteria. PURPOSE To systematically review diagnostic criteria and examinations performed in glaucoma prevalence studies over time and determine the quality of reporting. Accurate estimates of glaucoma prevalence are crucial to inform resource allocation. However, diagnosis of glaucoma comprises inherently subjective examinations and the cross-sectional nature of prevalence studies precludes monitoring for progression. METHODS A systematic review of PubMed, Embase, Web of Science, and Scopus was performed to examine diagnostic protocols used by glaucoma prevalence studies and evaluate uptake of the ISGEO criteria, introduced in 2002 to standardize glaucoma diagnosis in prevalence studies. Detection bias and compliance with the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) guidelines were evaluated. RESULTS Ten thousand five hundred forty-four articles were identified. After deduplication, 5589 articles were screened, yielding 136 articles pertaining to 123 studies. An absence of data in many countries was identified. Ninety-two percent of studies stated diagnostic criteria, and 62% used the ISGEO criteria since their publication. Weaknesses of the ISGEO criteria were identified. Temporal variations in the performance of various examinations were observed, including heterogeneity in angle assessment. Mean STROBE compliance was 82% (range 59-100%); 72 articles had a low risk of detection bias, 4 had a high risk, and 60 had some concerns. CONCLUSION Heterogeneous diagnostic definitions persist in glaucoma prevalence studies, despite introduction of the ISGEO criteria. Standardization of criteria remains imperative and the development of new criteria represent a valuable opportunity to achieve this goal. In addition, methods of determining diagnoses are poorly reported, suggesting a need for improvement in study conduct and reporting. Accordingly, we propose the Reporting of quality Of GlaUcoma Epidemiological Studies (ROGUES) Checklist. We have also identified a need for further prevalence studies in regions with limited data and to update Australian angle closure glaucoma prevalence. Design and reporting of future studies can be informed by this review's insights into diagnostic protocols previously used.
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Affiliation(s)
- Zayn Al-Timimi
- Rural Clinical School, University of New South Wales, Port Macquarie
| | - Jessie Huang-Lung
- School of Optometry and Vision Science, University of New South Wales, Sydney
| | - Lisa Keay
- School of Optometry and Vision Science, University of New South Wales, Sydney
| | - Paul Healey
- Clinical Ophthalmology and Eye Health, Westmead Clinical School
| | - Eleanor Yang
- School of Optometry and Vision Science, University of New South Wales, Sydney
| | - Hamish Dunn
- Rural Clinical School, University of New South Wales, Port Macquarie
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
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Torabi R, Harris A, Siesky B, Zukerman R, Oddone F, Mathew S, Januleviciene I, Vercellin ACV. Prevalence Rates and Risk Factors for Primary Open Angle Glaucoma in the Middle East. J Ophthalmic Vis Res 2021; 16:644-656. [PMID: 34840687 PMCID: PMC8593541 DOI: 10.18502/jovr.v16i4.9755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/09/2021] [Indexed: 12/16/2022] Open
Abstract
Glaucoma is a multifactorial disease and a leading cause of irreversible blindness worldwide. Current data has demonstrated the approximate distribution of primary open-angle glaucoma (POAG) in patients of European, African, Hispanic, and Eastern Asian descent. However, a significant gap in the literature exists regarding the prevalence of POAG in Middle Eastern (ME) populations. Current studies estimate ME POAG prevalence based on a European model. Herein we screened 65 total publications on ME prevalence of POAG and specific risk factors using keywords: "glaucoma", "prevalence", "incidence", "risk factor", "Middle East", "Mideast", "Persian", "Far East", as well as searching by individual ME countries through PubMed, Embase, Ovid, Scopus, and Trip searches with additional reference list searches from relevant articles published up to and including March 1, 2021. Fifty qualifying records were included after 15 studies identified with low statistical power, confounding co-morbid ophthalmic diseases, and funding bias were excluded. Studies of ME glaucoma risk factors that identify chromosomes, familial trend, age/gender, socioeconomic status, lifestyle, intraocular pressure, vascular influences, optic disc hemorrhage, cup-to-disc ratio, blood pressure, obstructive sleep apnea, and diabetes mellitus were included in this systematic review. We conclude that the prevalence of POAG in the ME is likely higher than the prevalence rate that European models suggest, with ME specific risk factors likely playing a role. However, these findings are severely limited by the paucity of population-level data in the ME. Well-designed, longitudinal population-based studies with rigorous inclusion and exclusion criteria are ultimately needed to accurately assess the epidemiology and specific mechanistic risk factors of glaucoma in ME populations.
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Affiliation(s)
- Rana Torabi
- Eugene and Marilyn Glick Eye Institute, Department of Ophthalmology, Indiana, University School of Medicine, Indianapolis, IN, USA
| | - Alon Harris
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brent Siesky
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ryan Zukerman
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Sunu Mathew
- Eugene and Marilyn Glick Eye Institute, Department of Ophthalmology, Indiana, University School of Medicine, Indianapolis, IN, USA
| | - Ingrida Januleviciene
- Eye Clinic of Medical Academy of Lithuanian University of Health Sciences, Kaunas, Lithuania
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Al-Yousuf N, Alaali H, Alsetri HM, Yusuf HE, Bhardwaj HK, Husain KA. Causes of Visual Impairment Among the Registered Visually Disabled: A Retrospective Study. Cureus 2021; 13:e17988. [PMID: 34540512 PMCID: PMC8445851 DOI: 10.7759/cureus.17988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2021] [Indexed: 12/30/2022] Open
Abstract
Purpose To study the causes of visual impairment among Bahraini patients registered as visually disabled. Materials and methods A retrospective descriptive study of all patients referred to the Ministry of Social Development for visual disability from January 2014 to December 2019 was performed. Information recorded were age, gender, the cause of the visual impairment, and visual acuity in the better eye. If a patient had multiple ophthalmic diseases, the untreatable disease causing visual impairment was recorded. Patients were considered to have visual impairment according to World Health Organization criteria. Results A total of 484 Bahraini patients were included in the study. The mean age was 57.3 years of age ranging from 3 to 100 years; 63% of the total cases were males. The most common cause of visual impairment was diabetic retinopathy (DR) 201 (41.53%), followed by glaucoma 161 (33.26%). This is followed by hereditary and congenital disorders 34 (7.02%), glaucoma combined with DR 21 (4.34%), other retinal diseases 17 (3.51), retinitis pigmentosa 14 (2.89), optic atrophy 9 (1.86), corneal disorders 8 (1.65%), age-related macular degeneration 8 (1.65%), and others 11 (0.83%). Conclusion DR and glaucoma are the major causes of visual impairment among adults. Complications leading to visual impairment of both disorders are avoidable. Prevention measures to be taken control these diseases and prevent their morbidity. Congenital and hereditary disorders are the most common causes of visual impairment among children.
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Affiliation(s)
| | - Haneen Alaali
- Ophthalmology, Salmaniya Medical Complex, Manama, BHR
| | - Hassan M Alsetri
- Chemistry and Biochemistry, University of California Los Angeles, Los Angeles, USA
| | - Hasan E Yusuf
- Ophthalmology, Salmaniya Medical Complex, Manama, BHR
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5
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Zhang N, Wang J, Li Y, Jiang B. Prevalence of primary open angle glaucoma in the last 20 years: a meta-analysis and systematic review. Sci Rep 2021; 11:13762. [PMID: 34215769 PMCID: PMC8253788 DOI: 10.1038/s41598-021-92971-w] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/19/2021] [Indexed: 12/16/2022] Open
Abstract
Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness in the world and is influenced by various sociodemographic factors. This meta-analysis aims to determine the worldwide prevalence of POAG in the adult general population for the last 20 years, and explore variation in prevalence by age, gender and geographical location. An electronic literature search was performed using the PubMed, Embase, and Web of Science databases. Population-based cross-sectional or cohort studies published in the last 20 years (2000–2020) that reported prevalence of POAG were recruited. Relevant studies meeting defined eligibility criteria were selected and reviewed systematically by meta-analysis. The prevalence of POAG was analyzed according to various risk factors. A random effect model was used for the meta-analysis. Fifty publications with a total of 198,259 subjects were included in this meta-analysis. The worldwide overall prevalence of POAG was 2.4% (95% CI 2.0 ~ 2.8%). The prevalence increases with age. Men are found to be more susceptible to POAG than women (RR 1.28, p < 0.01). Africa is found to have the highest prevalence of POAG (4.0%) among all continents. The current estimated global population of POAG is 68.56 million (95% CI 59.99 ~ 79.98). POAG is a worldwide vision threatening disease with high prevalence for the last 20 years. The population-based prevalence of POAG varies widely across individual studies, due to variations in risk factors of age, gender, and population geographic location.
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Affiliation(s)
- Nan Zhang
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.,Department of Ophthalmology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Jiaxing Wang
- Department of Ophthalmology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Ying Li
- Department of Ophthalmology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Bing Jiang
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China. .,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China.
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Helayel HB, AlOqab A, Subaie MA, Habash AA. Profile of Glaucoma in the Eastern Region of Saudi Arabia: A Retrospective Study. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2021; 9:167-174. [PMID: 34084108 PMCID: PMC8152387 DOI: 10.4103/sjmms.sjmms_116_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/19/2020] [Accepted: 01/20/2021] [Indexed: 11/24/2022]
Abstract
Background: Glaucomas remain asymptomatic until severe, indicating that the actual number of affected individuals may be higher than those diagnosed. Objective: To study the clinical patterns of glaucoma cases in the Eastern Province of Saudi Arabia. Patients and Methods: This retrospective study was conducted at King Fahd Hospital of the University, Al-Khobar, and Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia. The medical records of all patients with glaucoma who visited these hospitals from January 2015 to December 2018 were critically reviewed. Data regarding patients' demographic characteristic, clinical data and their medical and surgical management techniques were collected and analyzed. Results: A total of 999 patients were included, of which 52.9% were males, 94.8% were Saudi, and the mean age was 58.8 years. Bilateral involvement was observed in 82.3% of cases. Primary open-angle glaucoma (POAG) was the most prevalent type of glaucoma (27.7%), followed by secondary glaucomas (26.7%), primary angle-closure glaucoma (PACG) (18.2%), primary congenital glaucoma (2.7%), and juvenile open-angle glaucoma (2.2%), which were the most frequent glaucoma subsets. Conclusion: The study population was most affected by POAG, secondary glaucomas and PACG. Knowledge regarding prevalence of glaucoma is important to plan services, allocate resources, and prevent blindness.
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Affiliation(s)
- Halah Bin Helayel
- Department of Ophthalmology, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia.,Department of Ophthalmology, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Dammam, Saudi Arabia.,King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Aysha AlOqab
- Department of Ophthalmology, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia.,Department of Ophthalmology, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Dammam, Saudi Arabia.,Department of Ophthalmology, Bahrain Defence Force Hospital, Riffa, Bahrain
| | - Majed Al Subaie
- Department of Ophthalmology, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia.,Department of Ophthalmology, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Dammam, Saudi Arabia
| | - Ahmed Al Habash
- Department of Ophthalmology, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Dammam, Saudi Arabia
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7
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Zhang N, Wang J, Chen B, Li Y, Jiang B. Prevalence of Primary Angle Closure Glaucoma in the Last 20 Years: A Meta-Analysis and Systematic Review. Front Med (Lausanne) 2021; 7:624179. [PMID: 33537335 PMCID: PMC7847989 DOI: 10.3389/fmed.2020.624179] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 11/30/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose: This meta-analysis aims to investigate the worldwide prevalence of primary angle-closure glaucoma (PACG) and its risk factors in the last 20 years. Methods: We conducted a systematic review and meta-analysis of 37 population-based studies and 144,354 subjects. PubMed, Embase, and Web of Science databases were searched for cross-sectional or cohort studies published in the last 20 years (2000–2020) that reported the prevalence of PACG. The prevalence of PACG was analyzed according to various risk factors. A random-effects model was used for the meta-analysis. Results: The global pooled prevalence of PACG was 0.6% [95% confidence interval (CI) = 0.5–0.8%] for the last 20 years. The prevalence of PACG increases with age. Men are found less likely to have PACG than women (risk ratio = 0.71, 95% CI = 0.53–0.93, p < 0.01). Asia is found to have the highest prevalence of PACG (0.7%, 95% CI = 0.6–1.0%). The current estimated population with PACG is 17.14 million (95% CI = 14.28–22.85) for people older than 40 years old worldwide, with 12.30 million (95% CI = 10.54–17.57) in Asia. It is estimated that by 2050, the global population with PACG will be 26.26 million, with 18.47 million in Asia. Conclusion: PACG affects more than 17 million people worldwide, especially leading a huge burden to Asia. The prevalence of PACG varies widely across different ages, sex, and population geographic variation. Asian, female sex, and age are risk factors of PACG.
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Affiliation(s)
- Nan Zhang
- Department of Ophthalmology of Second Xiangya Hospital, Central South University, Changsha, China.,Department of Ophthalmology, School of Medicine, Emory University, Atlanta, GA, United States
| | - Jiaxing Wang
- Department of Ophthalmology, School of Medicine, Emory University, Atlanta, GA, United States
| | - Biyue Chen
- Department of Ophthalmology of Second Xiangya Hospital, Central South University, Changsha, China
| | - Ying Li
- Department of Ophthalmology, School of Medicine, Emory University, Atlanta, GA, United States
| | - Bing Jiang
- Department of Ophthalmology of Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China
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8
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Bagabas N, Ghazali W, Mukhtar M, AlQassas I, Merdad R, Maniyar A, Almarzouki N, Afreen H, Badeeb O, Wali S. Prevalence of Glaucoma in Patients with Obstructive Sleep Apnea. J Epidemiol Glob Health 2020; 9:198-203. [PMID: 31529938 PMCID: PMC7310817 DOI: 10.2991/jegh.k.190816.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 08/07/2019] [Indexed: 12/04/2022] Open
Abstract
To determine the prevalence of glaucoma in obstructive sleep apnea (OSA) patients and compare it with that of patients without OSA. Patients investigated for OSA using polysomnography at the sleep center of King Abdulaziz University Hospital were invited to participate in this cross-sectional case series study. American Academy of Sleep Medicine guidelines were used to diagnose OSA. Recruitment of patients with and without OSA was conducted from December 2013 to September 2015. Exclusion criteria included topical and systemic steroid use and presence of other ocular diseases. Two criteria, cup/disc ratio and visual field defects, were necessary for a glaucoma diagnosis. Among 84 adults enrolled, 44 (52%) had a confirmed diagnosis of OSA. Glaucoma prevalence was higher among individuals with OSA (16%) than among non-OSA individuals (8%), a difference that was not statistically significant. A consistent trend, which was not statistically significant after adjusting for cofounders, toward more glaucomatous changes was observed in OSA subjects. Although a trend toward higher glaucoma prevalence was observed in OSA patients, the difference was not statistically significant. As many variables contribute to the development of the two conditions, larger cohorts are needed to evaluate associations between glaucoma and OSA.
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Affiliation(s)
- Nahlah Bagabas
- Department of Radiology, National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Wafaa Ghazali
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mariam Mukhtar
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ibrahim AlQassas
- Department of International Medical Center, Jeddah, Saudi Arabia
| | - Roah Merdad
- Department of Family and Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ashfaque Maniyar
- Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Nawaf Almarzouki
- Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Halima Afreen
- Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Osama Badeeb
- Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Siraj Wali
- Sleep Medicine and Research Center, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
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9
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Khandekar R, Chauhan D, Yasir ZH, Al-Zobidi M, Judaibi R, Edward DP. The prevalence and determinants of glaucoma among 40 years and older Saudi residents in the Riyadh Governorate (except the Capital) - A community based survey. Saudi J Ophthalmol 2019; 33:332-337. [PMID: 31920442 PMCID: PMC6950957 DOI: 10.1016/j.sjopt.2019.02.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 02/18/2019] [Accepted: 02/27/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose To evaluate the prevalence of glaucoma and its determinants among adult Saudi Residents aged 40 years and older in the Riyadh Governorate (except the Capital). Methods A cluster-based sample of randomly selected citizens from six primary health center catchment areas were examined between 2014 and 2015. Data were collected on their glaucoma management. Assessment included measurement of intraocular pressure, optic nerve head evaluation and gonioscopy. Glaucoma suspects were referred for visual field testing. Result A total of 940 citizens were examined and 124 had glaucoma. The prevalence of glaucoma was 5.6% [95% Confidence interval (CI): 5.43–5.75] with an estimated 3758 cases of glaucoma in study area. Males had a significantly higher prevalence (7.62%) than females (3.48%). Glaucoma was not significantly associated to diabetes [Odds ratio (OR) = 1.1; (95% CI: 0.8–1.7); P = 0.5]. The variation in the prevalence of glaucoma by age group was not significant (P = 0.2). Open angle of anterior chamber was in 78% of glaucoma cases. The coverage of glaucoma management was 27.8%. Among known glaucoma patients were 69% were treatment-complaint. Of 124 glaucoma patients, 29 (23.5%) were aware of their diagnosis. Mild and moderate visual impairment was in 67% and 8 (6.5%) glaucoma patients while one (0.8%) patient was bilateral blind. Conclusion The prevalence of glaucoma was high. Identified determinants should be noted and accordingly a public health approach for early detection and adequate management is recommended.
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Affiliation(s)
- Rajiv Khandekar
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Deepti Chauhan
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Ziaul Haq Yasir
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Mohammed Al-Zobidi
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Ramzi Judaibi
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Deepak P Edward
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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10
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Prevalence of Selected Eye Diseases Using Data Harvested from Ophthalmic Checkup Examination of a Cohort of Two Thousand Middle Eastern and North African Subjects. J Ophthalmol 2018; 2018:8049475. [PMID: 29686888 PMCID: PMC5857300 DOI: 10.1155/2018/8049475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 10/06/2017] [Accepted: 02/15/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose To highlight the prevalence of selected ophthalmic diseases accidentally discovered at first-time screening of a large sample of patients from the Middle East and North Africa visiting a large referral university hospital checkup unit based in Cairo. Material and Methods A cross-sectional study of two thousand and thirteen subjects coming for routine ophthalmic medical checkups from different Middle East countries (mainly Egypt, Sudan, and Yemen). Patients were evaluated for prevalence of diabetic retinopathy, glaucoma, ocular hypertension, cataract, and amblyopia. Patients' demographic data and medical history were collected. Complete ophthalmic examination was performed. Investigations were done when needed to confirm suspected conditions. Results The study included 1149 males and 864 females. 652 Sudanese patients, 568 Yemeni patients, 713 Egyptian patients, and 63 patients from different Gulf and North African countries like Saudi Arabia, Qatar, Libya, and Jordan. Sudanese patients showed a higher percentage of glaucoma (13.3%) and ocular hypertension (8.3%). Yemeni patients showed the highest prevalence of amblyopia (6.7%), diabetic retinopathy (8.6%), and cataract (4.2%). The group of relatively higher economic classification seemed to show fewer prevalences of these ophthalmic conditions. Yemeni patients tended to have a high percentage of persistent myelinated nerve fibers. Conclusion Different ophthalmic conditions were discovered for the first time at the general checkup clinic. Certain conditions were more common than others in certain countries. The lack of regular checkups and the unavailability of medical services due to low to moderate socioeconomic status as well as political turbulence may account for the delay in initial diagnosis of many treatable conditions.
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11
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Alzuhairy S, Alalola FS, AlAkeel HA, Alayed DM, Al-Harbi IM, Al-Shetwi MM, Al-Nasser MA, AlJurayfani H, Mousa A. Profile and management outcomes of glaucoma cases at Qassim University Hospital. Int J Health Sci (Qassim) 2018; 12:20-24. [PMID: 30202404 PMCID: PMC6124836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE In view of the paucity of community-based data about glaucoma in Saudi Arabia, better planning to address visual disabilities due to glaucoma is a challenge. Providing hospital-based data from semi-urban places will complement the picture based on information of tertiary eye hospitals of capital. METHODS This is one-armed cohort study. All patients attending glaucoma subspecialty unit at our university hospital during 2014-2015 were evaluated for their demographic details, ocular status at presentation, management modalities, and follow-up status of treated eyes. The qualified and absolute success rates (intraocular pressure <22 mmHg with/without medication) were estimated. The determinants of success were analyzed. RESULTS We assessed 219 eyes of 122 patients of glaucoma patients. Bilateral glaucoma was in 97 (79.7%) patients. Primary chronic angle closure glaucoma in 102 (46.6%) eyes and primary open angle glaucoma (POAG) in 56 (25.6%) were the main types of glaucoma. More than half of the eyes with glaucoma had a normal functional vision, while 9.2% had vision <20/400. At presentation, 133 (60.7%) had undergone surgical procedure including laser iridotomy. At last follow-up, 135 (62%) of glaucomatous eyes were not using glaucoma medications. The decline in a number of glaucoma medications at last follow-up compared to 1st visit was statistically significant (P < 0.001). CONCLUSIONS At tertiary eye center of semi-urban area of Saudi Arabia had primary chronic angle-closure glaucoma (PCACG) as the main type of adult glaucoma. Vision does not seem to understand the severity of glaucoma at presentation. POAG cases were medically managed while PCACG cases were managed both with laser and surgeries.
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Affiliation(s)
- Sultan Alzuhairy
- Department of Ophthalmology, University Hospital, Alqassim, Saudi Arabia,Address for correspondence: Dr. Sultan A. Alzuhairy, Department of Ophthalmology, Qassim University, College of Medicine, Al Qassim, Burydah 51491, P.O. Box 4490, Saudi Arabia. Mobile: 00966555134777. E-mail: /
| | | | | | | | | | | | | | | | - Ahmed Mousa
- Department of Ophthalmology, King Saud University, Riyadh, Saudi Arabia
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12
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Hashemi H, Khabazkhoob M, Emamian MH, Shariati M, Yekta A, Fotouhi A. Distribution of intraocular pressure and its determinants in an Iranian adult population. Int J Ophthalmol 2016; 9:1207-14. [PMID: 27588277 DOI: 10.18240/ijo.2016.08.19] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 04/14/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To determine the distribution of intraocular pressure (IOP) and its determinants in an Iranian population. METHODS In a cross-sectional survey, random cluster sampling was conducted from the 40-64 years old population of Shahroud, in the north of Iran. All participants had optometry and ophthalmic exams. IOP was determined using the Goldmann tonometry method and biometric components were measured. RESULTS Of the 6311 people selected for the study, 5190 (82.2%) participated. The mean age of the participants was 50.9±6.2y and 58.7% of them were female. Mean IOP was 12.87±2.27 mm Hg. In this study 0.3% of the participants had an IOP higher than 21 mm Hg. The multiple linear regression model revealed that sex (Coef=-0.30; 95% CI: -0.43 to -0.17), diabetes (Coef=0.43; 95% CI: 0.19 to 0.67), high systolic blood pressure (Coef=0.02; 95% CI: 0.01 to 0.02), high body mass index (BMI) (Coef=0.03; 95% CI: 0.01 to 0.04), higher education (Coef=0.02, 95% CI: 0.01 to 0.04), thicker central corneal thickness (Coef=0.01; 95% CI: 0.01 to 0.02), and myopic shift in spherical equivalent (Coef=-0.14; 95% CI: -0.18 to -0.10) significantly correlated with high IOP. CONCLUSION The IOP in this 40-64 years old population is low overall. In the north of Iran, average IOP is statistically significantly correlated with female sex, diabetes, higher BMI, systolic blood pressure, higher education, thicker cornea, and myopic refractive error.
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Affiliation(s)
- Hassan Hashemi
- Ophthalmic Epidemiology, Noor Research Center, Noor Eye Hospital, Tehran 1968653163, Iran; Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran 1968653163, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran 1634858433, Iran
| | - Mohammad Hassan Emamian
- Health Related Social and Behavioral Sciences Research Center, Shahroud University of Medical Sciences, Shahroud 3614773947, Iran
| | - Mohammad Shariati
- Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran 1417613181, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad 9183896858, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran 1417613181, Iran
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Kyari F, Entekume G, Rabiu M, Spry P, Wormald R, Nolan W, Murthy GVS, Gilbert CE. A Population-based survey of the prevalence and types of glaucoma in Nigeria: results from the Nigeria National Blindness and Visual Impairment Survey. BMC Ophthalmol 2015; 15:176. [PMID: 26653326 PMCID: PMC4676891 DOI: 10.1186/s12886-015-0160-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 11/24/2015] [Indexed: 12/13/2022] Open
Abstract
Background Glaucoma is the leading cause of irreversible blindness worldwide. There tends to be a lower reporting of glaucoma in Africa compared to other blinding conditions in global burden data. Research findings of glaucoma in Nigeria will significantly increase our understanding of glaucoma in Nigeria, in people of the West African diaspora and similar population groups. We determined the prevalence and types of glaucoma in Nigeria from the Nigeria National Blindness and Visual Impairment cross-sectional Survey of adults aged ≥40 years. Methods Multistage stratified cluster random sampling with probability-proportional-to-size procedures were used to select a nationally representative sample of 15,027 persons aged ≥40 years. Participants had logMAR visual acuity measurement, FDT visual function testing, autorefraction, A-scan biometry and optic disc assessment. Participants with visual acuity of worse than 6/12 or suspicious optic discs had detailed examination including Goldmann applanation tonometry, gonioscopy and fundus photography. Disc images were graded by Moorfields Eye Hospital Reading Centre. Glaucoma was defined using International Society of Geographical and Epidemiological Ophthalmology criteria; and classified into primary open-angle or primary angle-closure or secondary glaucoma. Diagnosis of glaucoma was based on ISGEO classification. The type of glaucoma was determined by gonioscopy. Results A total of 13,591 participants in 305 clusters were examined (response rate 90.4 %). Optic disc grading was available for 25,289 (93 %) eyes of 13,081 (96 %) participants. There were 682 participants with glaucoma; a prevalence of 5.02 % (95 % CI 4.60–5.47). Among those with definite primary glaucoma that had gonioscopy (n = 243), open-angle glaucoma was more common (86 %) than angle-closure glaucoma (14 %). 8 % of glaucoma was secondary with the commonest causes being couching (38 %), trauma (21 %) and uveitis (19 %). Only 5.6 % (38/682) of participants with glaucoma knew they had the condition. One in every 5 persons with glaucoma (136;20 %) was blind i.e., visual acuity worse than 3/60. Conclusion Nigeria has a high prevalence of glaucoma which is largely open-angle glaucoma. A high proportion of those affected are blind. Secondary glaucoma was mostly as a consequence of procedures for cataract. Public health control strategies and high quality glaucoma care service will be required to reduce morbidity and blindness from glaucoma.
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Affiliation(s)
- Fatima Kyari
- International Centre for Eye Health (ICEH), Clinical Research Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, WC1E 7HT, UK. .,Department of Ophthalmology, College of Health Sciences (CHS), University of Abuja, Abuja, Nigeria.
| | | | - Mansur Rabiu
- Prevention of Blindness Union, Riyadh, Saudi Arabia.
| | - Paul Spry
- Bristol Eye Hospital, University Hospitals, Bristol NHS Foundation Trust, Bristol, UK.
| | - Richard Wormald
- International Centre for Eye Health (ICEH), Clinical Research Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, WC1E 7HT, UK. .,Moorfields Eye Hospital, London, United Kingdom.
| | | | - Gudlavalleti V S Murthy
- International Centre for Eye Health (ICEH), Clinical Research Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, WC1E 7HT, UK. .,Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Andhra Pradesh, India.
| | - Clare E Gilbert
- International Centre for Eye Health (ICEH), Clinical Research Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, WC1E 7HT, UK.
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Chan EW, Li X, Tham YC, Liao J, Wong TY, Aung T, Cheng CY. Glaucoma in Asia: regional prevalence variations and future projections. Br J Ophthalmol 2015; 100:78-85. [DOI: 10.1136/bjophthalmol-2014-306102] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 06/04/2015] [Indexed: 11/03/2022]
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Analysis of Factors Affecting Patients' Compliance to Topical Antiglaucoma Medications in Egypt as a Developing Country Model. J Ophthalmol 2015; 2015:234157. [PMID: 26167292 PMCID: PMC4488247 DOI: 10.1155/2015/234157] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 06/02/2015] [Accepted: 06/03/2015] [Indexed: 11/17/2022] Open
Abstract
Purpose. To study factors affecting patients' compliance to antiglaucoma medications in Egypt where there are unique factors as a developing country. Patients and Methods. A cross-sectional descriptive study on 440 Egyptian patients with open angle glaucoma (OAG) recruited for over two years. The patients were thoroughly interviewed about their age, education level, duration of glaucoma, difficulty in instilling the drops, medication regimens, a family history of glaucoma, knowledge of the disease, and the presence of medical insurance. Results. 236 (53.6%) were noncompliant compared to 204 (46.4%) who were compliant. Females had a tendency for higher compliance (p=0.061). Patient age above 50 years and low level of education and negative family history of glaucoma were factors significantly associated with poor compliance (p < 0.0001). Polytherapy and lack of medical insurance could be contributing factors. Conclusion. Egyptian patients have a high rate of noncompliance compared to the average in literature. Great effort is needed in educating patients about the importance of medications and the risk and the prognosis of this disease. Economic factors must also be taken into consideration in developing countries with large number of poor patients. We recommend simplifying drug regimens, incorporating electronic dose monitors, and creating reminders for follow-up visits of glaucoma patients.
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The prevalence of primary angle closure glaucoma in adult Asians: a systematic review and meta-analysis. PLoS One 2014; 9:e103222. [PMID: 25057993 PMCID: PMC4110010 DOI: 10.1371/journal.pone.0103222] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Accepted: 06/25/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Primary angle closure glaucoma (PACG) is higher in Asians than Europeans and Africans, with over 80% of PACG worldwide in Asia. Previous estimates of PACG were based largely on early studies, mostly using inappropriate case definitions. Therefore, we did a systematic review and meta-analysis to estimate the prevalence of PACG in adult Asian populations and to quantify its association with age, gender, and region. METHODS All primary reports of population-based studies that reported the prevalence of PACG in adult Asian populations were identified. PACG case definition was compatible with the ISGEO definition. Twenty-nine population-based studies were included. The overall pooled prevalence estimates were calculated using a random effect model, and ethnicity-, age- and gender-specific pooled prevalence estimates were also calculated. RESULTS The overall pooled prevalence of PACG in those of adult Asians was 0.75% (95% CI, 0.58, 0.96). Ethnicity-specific pooled prevalence estimates were 0.97% (0.22, 4.27) in Middle East group, 0.66% (0.23, 1.86) in South East Asia group, 0.46% (0.32, 0.64) in India group, 1.10% (0.85, 1.44) in China group, and 1.19% (0.35, 3.98) in Japan group, respectively. Age-specific prevalence was 0.21% (0.12, 0.37) for those 40-49 years, 0.54% (0.34, 0.85) for those 50-59 years, 1.26% (0.93, 1.71) for those 60-69 years, and 2.32% (1.74, 3.08) for those 70 years or above. The overall female to male ratio of the PACG prevalence was 1.51∶1 (95% CI 1.01, 2.28). CONCLUSIONS PACG affects approximately 0.75% adult Asians, increasing double per decade, and 60% of cases being female. The prevalence rates vary greatly by ethnic region.
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Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology 2014; 121:2081-90. [PMID: 24974815 DOI: 10.1016/j.ophtha.2014.05.013] [Citation(s) in RCA: 3756] [Impact Index Per Article: 375.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 03/11/2014] [Accepted: 05/15/2014] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Glaucoma is the leading cause of global irreversible blindness. Present estimates of global glaucoma prevalence are not up-to-date and focused mainly on European ancestry populations. We systematically examined the global prevalence of primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), and projected the number of affected people in 2020 and 2040. DESIGN Systematic review and meta-analysis. PARTICIPANTS Data from 50 population-based studies (3770 POAG cases among 140,496 examined individuals and 786 PACG cases among 112 398 examined individuals). METHODS We searched PubMed, Medline, and Web of Science for population-based studies of glaucoma prevalence published up to March 25, 2013. Hierarchical Bayesian approach was used to estimate the pooled glaucoma prevalence of the population aged 40-80 years along with 95% credible intervals (CrIs). Projections of glaucoma were estimated based on the United Nations World Population Prospects. Bayesian meta-regression models were performed to assess the association between the prevalence of POAG and the relevant factors. MAIN OUTCOME MEASURES Prevalence and projection numbers of glaucoma cases. RESULTS The global prevalence of glaucoma for population aged 40-80 years is 3.54% (95% CrI, 2.09-5.82). The prevalence of POAG is highest in Africa (4.20%; 95% CrI, 2.08-7.35), and the prevalence of PACG is highest in Asia (1.09%; 95% CrI, 0.43-2.32). In 2013, the number of people (aged 40-80 years) with glaucoma worldwide was estimated to be 64.3 million, increasing to 76.0 million in 2020 and 111.8 million in 2040. In the Bayesian meta-regression model, men were more likely to have POAG than women (odds ratio [OR], 1.36; 95% CrI, 1.23-1.52), and after adjusting for age, gender, habitation type, response rate, and year of study, people of African ancestry were more likely to have POAG than people of European ancestry (OR, 2.80; 95% CrI, 1.83-4.06), and people living in urban areas were more likely to have POAG than those in rural areas (OR, 1.58; 95% CrI, 1.19-2.04). CONCLUSIONS The number of people with glaucoma worldwide will increase to 111.8 million in 2040, disproportionally affecting people residing in Asia and Africa. These estimates are important in guiding the designs of glaucoma screening, treatment, and related public health strategies.
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Affiliation(s)
- Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Xiang Li
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Statistics and Applied Probability, National University of Singapore, Singapore
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Harry A Quigley
- Glaucoma Service and Dana Center for Preventive Ophthalmology, Wilmer Ophthalmological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Duke-NUS Graduate Medical School, Singapore.
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Alwadani F. Effect of Tight Naqab on Intraocular Pressure: A Prospective Study. JOURNAL OF MEDICAL SCIENCES 2013. [DOI: 10.3923/jms.2013.839.842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Qureshi BM, Mansur R, Al-Rajhi A, Lansingh V, Eckert K, Hassan K, Ravilla T, Muhit M, Khanna RC, Ismat C. Best practice eye care models. Indian J Ophthalmol 2013; 60:351-7. [PMID: 22944741 PMCID: PMC3491257 DOI: 10.4103/0301-4738.100526] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Since the launching of Global Initiative, VISION 2020 "the Right to Sight" many innovative, practical and unique comprehensive eye care services provision models have evolved targeting the underserved populations in different parts of the World. At places the rapid assessment of the burden of eye diseases in confined areas or utilizing the key informants for identification of eye diseases in the communities are promoted for better planning and evidence based advocacy for getting / allocation of resources for eye care. Similarly for detection and management of diabetes related blindness, retinopathy of prematurity and avoidable blindness at primary level, the major obstacles are confronted in reaching to them in a cost effective manner and then management of the identified patients accordingly. In this regard, the concept of tele-ophthalmology model sounds to be the best solution. Whereas other models on comprehensive eye care services provision have been emphasizing on surgical output through innovative scales of economy that generate income for the program and ensure its sustainability, while guaranteeing treatment of the poorest of the poor.
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Affiliation(s)
- Babar M Qureshi
- Comprehensive Health and Education Forum International, Pakistan
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