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Acta Scientific Ophthalmology (ISSN: 2582-3191) World Glaucoma Week in Port Harcourt: Comparison of Yield and Public Awareness of Glaucoma Services in two Consecutive Years

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Acta Scientific Ophthalmology (ISSN: 2582-3191) World Glaucoma Week in Port Harcourt: Comparison of Yield and Public Awareness of Glaucoma Services in two Consecutive Years

Acta Scientific Ophthalmology (ISSN: 2582-3191)
Volume 3 Issue 3 March 2020
World Glaucoma Week in Port Harcourt: Comparison of Yield and Public
Awareness of Glaucoma Services in two Consecutive Years
AA Onua and EA Awoyesuku*
Department of Ophthalmology, University of Port Harcourt, Nigeria
*Corresponding Author: EA Awoyesuku, Department of Ophthalmology, University
of Port Harcourt, Nigeria.
Research Article
Received: February 12, 2020
Published: February 29, 2020
© All rights are reserved by AA Onua and EA
Awoyesuku .
Abstract
Keywords: Awareness; Screening for Glaucoma; World Glaucoma Week
Introduction
Background: Glaucoma is a leading cause of irreversible blindness worldwide. Ignorance and poverty are known factors for late
presentation. Early diagnosis and treatment are indispensable tools in curbing the menace of visual impairment from glaucoma. The
Rivers State branch of the Ophthalmological Society of Nigeria (OSN) creates awareness and undertakes screening of the populace
for glaucoma during World Glaucoma Weeks observed annually. The aim of this study is to compare the socio-demographics of par-

Materials and Method: Cross-sectional survey of 173 clients presenting for glaucoma screening in 2018 and 2019 World Glaucoma
Weeks at the ophthalmology clinic of the University of Port Harcourt Teaching Hospital. Socio-demographic characteristics, pattern
of referral, medium of awareness, educational status and occupation of the study-participants were obtained and analyzed.
Results: One hundred and three participants were females. The mean age of the study participants was 39.3 ± 14.6 years. Age group
(40 - 49 years) had the highest proportion of participants (25.4%). The yield was 7.5%. Forty participants in 2018 were informed of

while 50 (28.9%) were referred through posters.
Conclusion: The yield of glaucoma cases was 7.5%. Our study shows that dissemination of information related to glaucoma to mem-

       
for the visual impairment and blindness often seen among glau-
coma patients in Sub-Sahara Africa. Lack of glaucoma awareness,
positive family history and illiteracy were associated with late
presentation of glaucoma [1]-
isting glaucoma services helps in providing access to quality care,
more understanding of the disease, leading to better control and
prevention of early onset of blindness from glaucoma. Screening of
the general population for glaucoma is a veritable tool in identify-
-
  
et al. in a study in South-West Nigeria observed the need to inten-
sify present efforts aimed at increasing public awareness, empha-
sizing the irreversible nature of the disease, as well as encouraging
[1].
Mass public awareness campaign and screening had been ob-
served to impact positively on early detection of glaucoma [1,2].
Furthermore, the positive impact of frequent free eye camps or-
DOI: 10.31080/ASOP.2020.03.0104
Citation: AA Onua and EA Awoyesuku. “World Glaucoma Week in Port Harcourt: Comparison of Yield and Public Awareness of Glaucoma Services in two
Consecutive Years”. Acta Scientific Ophthalmology 3.3 (2020): 01-05.
ganized by different non-governmental organizations, especially
in rural areas, cannot be over-emphasized. Glaucoma suspects
are usually referred to our eye clinic from such eye camps. Apart
from improved awareness, the level of education of patients and
-
lationship with earlier detection of glaucoma [2,3]. Events under-
taken by ophthalmologists and other eye care practitioners during
World Glaucoma Weeks at various community levels also increase
availability of ophthalmology services, counseling and screening
and referral of ocular morbidities to specialist centers [3]. The
importance of these activities during the World Glaucoma Weeks
in rural and suburban areas cannot be over-emphasized. More
awareness campaigns are necessary in order to educate glaucoma
patients and communities, and counseling services should be made
available to families of sufferers. Educating the general public on
the need for early presentation to ophthalmologists and not to oth-
er health practitioners may make early diagnosis and management
feasible, hence improving the prognosis of the disease.
Materials and Methods
This was a cross-sectional survey of clients presenting for glau-
coma screening during the 2018 and 2019 editions of World Glau-
coma Week at the Ophthalmology clinic of the University of Port
Harcourt Teaching Hospital (UPTH). Socio-demographic character-
istics, pattern of referral, medium of awareness, educational status
and occupation of the study-participants were obtained. In 2018,
glaucoma patients undertaking treatment in UPTH were requested

2019 edition, invitation of the public was given out via radio an-
nouncement and jingles, social media and posters displaced in dif-
ferent strategic points in Port Harcourt municipality. Assessment
of the Vertical Cup Disc Ratio of the Optic nerve head was used to
determine glaucomatous disc (VCDR of 0.8 - 1.0); Glaucoma Sus-
pect (VCDR > 0.5 - 0.7) for glaucoma was done by the use of indirect
ophthalmoscope. All data were cross checked for accuracy, entered
into a proforma and were analyzed using commercially available
statistical data management software- Statistical Package for So-
cial Sciences (IBM-SPSS) version 25. Distribution was described as
mean and standard deviation. Continuous variables were reported
with tables. Analysis of Variance (ANOVA) was used to determine


Consent and ethical clearance
Ethical clearance was obtained from the Ethical Committee of
University of Port Harcourt Teaching Hospital. Informed written
consent and assent were obtained from each client before enrol-
ment into the study in accordance with Helsinki Declaration in-
volving human subjects.
Results
A total of 173 clients participated in the study, 103 (59.5%)
were females. Male to female ratio was 1:1.5. The mean age of the
study participants was 39.3 ± 14.6 years; with age range of 6 - 83
years. Age group (40 - 49 years) had the highest proportion of par-
ticipants (25.4%). The differences in the proportion of age groups
-
cant (p = 0.794).
Age Group (Years) Male (%) Female (%) Total (%)
 5 (2.9) 8 (4.6) 13 (7.5)
20-29 12 (6.9) 15 (8.7) 27 (15.6)
30-39 14 (8.1) 28 (16.2) 42 (24.3)
40-49 17 (9.8) 27 (15.6) 44 (25.4)
50-59 12 (6.9) 16 (9.3) 28 (16.2)
60 and Above 10 (5.8) 9 (5.2) 19 (11.0)
Total 70 (40.5) 103 (59.5) 173 (100)
Pearson’s Chi- Square=2.381 df=5 p= 0.794
Table 1: Age and Gender Distribution of the Study Participants in
the Two Years.
In 2018 edition of World Glaucoma week, a total of 40 partici-
pants were screened for glaucoma. The Mean age of participants
was 36.3 ± 14.7years, with age range of 10 - 68years. Male to fe-
male ratio was 1:1.4. Participants of 30-39 years constituted the
highest (30%).
Age Group (Years) Male (%) Female (%) Total (%)
0-19 2 (5.0) 4 (10.0) 6 (15.0)
20-29 3 (7.5) 4 (10.0) 7 (17.5)
30-39 5 (12.5) 7 (17.5) 12 (30.0)
40-49 2 (5.0) 5 (12.5) 7 (17.5)
50-59 3 (7.5) 1 (2.5) 4 (10.0)
60 and Above 2 (5.0) 2 (5.0) 7 (17.5)
Total 17 (42.5) 23 (57.5) 40 (100)
Table 1a: Age and Gender Distribution of the Study
Participants in 2018.
02
World Glaucoma Week in Port Harcourt: Comparison of Yield and Public Awareness of Glaucoma Services in two Consecutive Years
Citation: AA Onua and EA Awoyesuku. “World Glaucoma Week in Port Harcourt: Comparison of Yield and Public Awareness of Glaucoma Services in two
Consecutive Years”. Acta Scientific Ophthalmology 3.3 (2020): 01-05.
In 2019 edition of World Glaucoma week, a total of 133 partici-
pants were screened for glaucoma. The Mean age of participants
was 42.3 ± 14.6 years with age range of 6-83. Male to female ra-
tio was 1:1.6. Participants of 40 - 49 years constituted the highest
(25.5%) (Table 1b).
Age Group (Years) Male (%) Female (%) Total (%)
0-19 3 (2.3) 4 (3.0) 7 (5.3)
20-29 9 (6.8) 11 (8.2) 20 (15.0)
30-39 9 (6.8) 21 (15.8) 30 (22.6)
40-49 12 (9.0) 22 (16.5) 34 (25.5)
50-59 9 (6.8) 15 (11.3) 24 (18.1)
60 and Above 10 (7.6) 8 (6.0) 18 (13.5)
Total 52 (39.2) 81 (60.8) 133 (100)
Table 1b: Age and Gender Distribution of the Study
Participants in 2019.
Table 2 shows that the 40 participants in 2018 were informed
       
were glaucoma patients receiving various glaucoma services of-
fered in the Ophthalmology clinic of University of Port Harcourt
Teaching Hospital. In the 2019 edition of the program, 73 (42.2%)
of the clients were referred through radio while 50 (28.9%) were
referred through poster. Client referral from various social media
was 9 (5.2%) while only 2 (1.2%) clients participated as a result
of information from family members who are glaucoma patients.
Year Patient
(%)
Poster
(%)
Radio
(%)
Social
media
(%)
Total (%)
2018 40 (23.1) - - - 40 (23.1)
2019 2 (1.2) 50 (28.9) 73 42.2) 9 (5.2) 133 (76.9)
Total 42 (24.3) 50 (28.9) 73 (42.2) 9 (5.2) 173 (100)
Table 2: Comparison of Pattern of referral of clients in the
Study Population.
Table 3 shows that 103 (59.5%) of the study participants were
civil /public servants, 36 (20.8%) were students, 25 (14.5%) were
business men and women while retirees constituted 4% and ap-
plicants were 1.6% of the participants.
Table 4 shows that 107 (61.8%) study participants had tertiary
education, 51 (29.5%) had secondary education while 15 (8.7%)
of the clients had primary education. The difference in the educa-
tional status of the participants in the various groups was not sta-

Occupation 2018 (%) 2019 % Total (%)
Business 5 (2.9) 20 (11.6) 25 (14.5)
Civil service 18 (10.4) 85 (49.1) 103 (59.5)
Retiree 4 (2.3) 3 (1.7) 7 (4.0)
Student 13 (7.5) 23 (13.3) 36 (20.8)
Applicants 0 (0) 2 (1.6) 2 (1.6)
Total 40 (23.1) 133 (76.9) 173 (100)
Table 3: Comparison of Study participants by Occupation.
Education 2018
Per-
cent-
age
2019
Per-
cent-
age
Total (%)
Tertiary 21 (12.1) 86 (49.7) 107 (61.8)
Secondary 13 (7.5) 38 (21.9) 51 (29.5)
Primary 6 (3.5) 9 (5.2) 15 (8.7)
Total Pear-
son’s Chi
Square=
3.300
40 (23.1) 133
P= 0.192 (76.9) 173 (100)
Table 4: Comparison of Study Participants by Educational Level.
Table 5 shows that a total of 13 clients (7.5%) were screened
positive for glaucoma, out of which number, 9 were harvested in
2018. The difference in the VCDR among the various participants

Discussion
The World Glaucoma Association subcommittee on screening
advocates screening for glaucoma as a means of creating public
awareness of the disease and creating an avenue for detection of
vision disorders in medically underserved communities [4].
Glaucoma is a leading cause of blindness and is generally as-
ymptomatic until late in the disease, therefore early diagnosis an
essential part of the control strategy [5].
Gender
More females accessed the free screening programme from our
-
pared.
03
World Glaucoma Week in Port Harcourt: Comparison of Yield and Public Awareness of Glaucoma Services in two Consecutive Years
Citation: AA Onua and EA Awoyesuku. “World Glaucoma Week in Port Harcourt: Comparison of Yield and Public Awareness of Glaucoma Services in two
Consecutive Years”. Acta Scientific Ophthalmology 3.3 (2020): 01-05.
Females have been known to access free health programmes
more probably because of economic disadvantages they are unable
to pay for fee-paying health programmes [6,7]. There is no clear
gender predilection for open angle glaucoma; but women tend to
outlive men and represent 60% of all glaucoma cases combined,

protective of the optic nerve [7].
Age
Participants of 40 - 49 years constituted the highest (25.5%)
number of participants in our study when comparing the two years.
Age is an established risk factor for glaucoma [8]. In a study
by Song., et al. [9] comparing two cohorts of patients referred for
glaucoma screening the mean age of participants were 55.7 and
51.7years respectively. Al-Aswad., et al. [10] while screening high
risk population had the highest age range of 40 - 64years and more
female than male participants. In a community-based screening for
glaucoma in Nigeria the highest age range of participants present-
ing were 41- 50years [11] while in South western Nigeria the mean
age of participants for screening was 61.9years [9] and 56.3years
[12].
Referral route/ occupation of participants
In 2018 our participants were referred mainly through other
patients while in 2019, other modes of referral were used radio
constituting the highest (42.2%). In both years the highest num-
bers of participants were civil servants 59.5%. In glaucoma screen-
ing program in South Eastern Nigeria radio was the commonest
mode of referral and business /self-employed people consisted of
the highest number of participants [13] In a study on the role of
mass media in the creation of awareness for glaucoma, it was found

during Glaucoma awareness week [14]. The recommendation is for
this to be on a continuous basis.
Glaucoma yield
A total of 13 clients (7.5%) were screened positive for glau-
coma, out of which number, 9 were harvested in 2018. The differ-
ence in the VCDR among the various participants in this study was

from the entire population but it is noteworthy that most of the
        
family relatives. This agrees with the consensus statement by the
World Glaucoma association that glaucoma screening is more vi-
able if targeted at glaucoma patient relatives [15]. This was also
buttressed by a study by Nathaniel G. [16] who had a prevalence
of glaucoma of 13.7% for offspring of glaucoma patients and 5.3%
for siblings of glaucoma patient during an opportunistic glaucoma

Conclusion
Glaucoma screening is a very important means of early detec-
          
  -
nouncements and posters displayed at strategic locations could be
effective in our environment.
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World Glaucoma Week in Port Harcourt: Comparison of Yield and Public Awareness of Glaucoma Services in two Consecutive Years
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World Glaucoma Week in Port Harcourt: Comparison of Yield and Public Awareness of Glaucoma Services in two Consecutive Years
Citation: AA Onua and EA Awoyesuku. “World Glaucoma Week in Port Harcourt: Comparison of Yield and Public Awareness of Glaucoma Services in two
Consecutive Years”. Acta Scientific Ophthalmology 3.3 (2020): 01-05.
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