scholarly journals Relevance of mandatory glaucoma screening in all patients from outreach cataract camps referred to a base hospital for cataract surgery

2020 ◽  
Vol 7 (10) ◽  
pp. 4037
Author(s):  
Vijay P. S. Tomar ◽  
Sandeep Sharma ◽  
Rahul Bhardwaj ◽  
Arjun Bamel ◽  
Amrapali Bobade ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Medical Records ◽  
Open Angle Glaucoma ◽  
Angle Closure ◽  
Glaucoma Screening ◽  
Primary Angle Closure ◽  
Base Hospital ◽  
Primary Angle Closure Glaucoma ◽  
The Mean ◽  
Systemic Examination

Background: Glaucoma is the first cause of irreversible blindness and second leading cause of visual loss in the world. The purpose of this study was to conduct mandatory glaucoma screening and to find out the prevalence of glaucoma, in all patients referred for cataract surgery to a base hospital. Methods: A retrospective analysis was conducted of all patients referred from rural screening camps to base hospital for cataract surgery. Medical records of 5024 consecutive patients referred to base hospital from the month of January to June 2019 were reviewed. All these 5024 patients underwent comprehensive ophthalmic and systemic examination. Those patients in which glaucoma was suspected, were referred to glaucoma clinic for further evaluation.Results: Total 5024 patient’s records were analysed retrospectively. The mean age of the participants was 57.2±8.149 ranged from 40-95 years and average age of patients having cataract with glaucoma was 61.3±9.423. Total patients of glaucoma with cataract were 188 (3.7%). The prevalence of primary open angle glaucoma (POAG) and Primary angle closure glaucoma (PACG) was 1.69% and 1.17% respectively while secondary glaucoma was found in 0.88% of the patients. The prevalence of ocular hypertension, PAC and PACS was 0.33%, 0.29% and 0.83% respectively.Conclusion: The prevalence of glaucoma in this study was 3.7% of those planned for cataract surgery. Therefore, mandatory glaucoma screening in all patients from outreach cataract camps would result in detection of a large number of those with undiagnosed glaucoma. 

scholarly journals Ultrasound biomicroscopic comparison of primary open-angle glaucoma and primary angle-closure glaucoma eyes in dark and light conditions

2015 ◽  
Vol 14 (1) ◽  
pp. 5-16
Author(s):  
Stephanie Ming Young ◽  
Maria CD Aquino ◽  
Noor Shabana ◽  
Ce Zheng ◽  
Seng Chee Loon ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Light Conditions ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
The Mean ◽  
Inferior Quadrant

Background: With the use of ultrasound biomicroscopy, we aim to look at differences in anterior segment parameters of eyes with primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) in dark and light conditions.Methods: Ultrasound biomicroscopy was performed for 30 subjects with PACG and 30 subjects with POAG at initial presentation before any treatment. Measurements of angle opening distance (AOD-500 and AOD-750) and trabecular-iris space area (TISA-500 and TISA-750) 500 and 750 mm from the scleral spur in both dark and light conditions were made. Anterior chamber depth (ACD) and axial length (AL) were also measured.Results: The mean age of PACG patients was 67.6 ± 9.6 years and POAG patients 62.1 ± 13.9 years. The mean ACD (2.70 ± 0.53mm) in PACG patients was significantly different from that (3.32 ± 0.52mm) of POAG patients (p<0.0001). There were also significant differences (p=0.0004) in the mean AL of PACG (22.91 ± 0.86mm) and POAG (24.47 ± 1.67mm) patients. Significant differences between POAG and PACG eyes were found for TISA-500, TISA-750, AOD-500 and AOD-750 in both light and dark conditions (p<0.001 for all). The light-dark differences in PACG eyes were smaller than that of POAG eyes for all AOD and TISA values in the inferior, superior, nasal and temporal quadrants. However, with the exception of AOD-750 in the inferior quadrant (p=0.0524), there were no significant differences in light-dark changes between POAG and PACG eyes for all parameters in the 4 quadrants.Conclusions: Ultrasound biomicroscopy is a useful tool in the diagnosis and management of glaucoma. We found significant differences in mean AL, ACD, TISA-500, TISA-750, AOD-500 and AOD-750 between PACG and POAG eyes. However, there were no significant differences between PACG and POAG eyes in terms of light-dark difference in anterior segment parameters, except for AOD-750 in the inferior quadrant. Further evaluation of the above findings could be done in future with a larger population.

Achieving low target intraocular pressures in severe glaucoma

2020 ◽  
pp. 112067212097990
Author(s):  
Gazella Bruce Warjri ◽  
Talvir Sidhu ◽  
Azmira Kishan ◽  
Aswini Kumar Behera ◽  
Jyoti Shakrawal ◽  
...  
Keyword(s):  
Open Angle Glaucoma ◽  
Angle Closure ◽  
Mean Deviation ◽  
Age Group ◽  
Open Angle ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Humphrey Field Analyzer ◽  
The Mean

Purpose: This study aimed to assess details of therapy required to achieve an intraocular pressure (IOP) of ⩽12 mmHg in patients with severe glaucoma of different etiologies. Methods: Patients with a follow-up of at least 1 year, who fulfilled inclusion criteria were selected, and data analyzed with respect to baseline IOP, number of medications, and/or surgeries required to achieve an IOP of ⩽12 mmHg and ⩾6 mmHg. Final IOP, visual field status and medications/surgery required were noted. Results: About 127 eyes of 85 patients met all criteria. There were 48 eyes having primary angle closure glaucoma (PACG), 16 eyes with primary open angle glaucoma (POAG), 17 eyes of juvenile open angle glaucoma (JOAG), and 46 eyes of secondary glaucoma. The mean baseline IOP was 33.14 ± 11.07 mmHg and final IOP 10.25 ± 1.81 mmHg. In the age group >40 years, 29.63% of patients were controlled on medication as compared to 9.09% and 5.71% in the age group of <20 years and 20–40 years ( p = 0.007). With a baseline IOP of <25 mmHg, 48.65% required a trabeculectomy, whereas for 25–30, and >30 mmHg, 62.5% and 97.29% respectively, required surgery ( p < 0.001).66.67% of patients having mean deviation of −12 to −16 dB (decibels) on Humphrey field analyzer (HFA) underwent surgery to achieve target IOP in comparison to 83.52% who had mean deviation greater than −16 dB ( p = 0.036). Conclusion: Only 21.26% of severe glaucoma eyes could be controlled on medications alone. A baseline IOP of >25 mmHg, age <40 years and mean deviation worse than −16 dB, had a higher frequency of trabeculectomies to achieve an IOP of ⩽12 mmHg.

scholarly journals Effect of Cataract Surgery on Intraocular Pressure in Glaucoma Patients

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Shua Azam ◽  
Abdul Hameed Talpur ◽  
Mahak Shaheen ◽  
Sadia Bukhari
Keyword(s):  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Angle Closure ◽  
Inclusion Criteria ◽  
Primary Angle Closure Glaucoma ◽  
Closed Angle ◽  
Operative Assessment

Purpose:  To determine the change in intraocular pressure after cataract surgery in patients diagnosed with glaucoma. Study Design:  Interventional case series. Place and Duration of Study:  Glaucoma Clinic. Al-Ibrahim Eye Hospital (AIEH) Karachi, Pakistan from May to October, 2019. Methods:  Thirty-eight patients diagnosed with glaucoma and cataract and registered in glaucoma clinic were recruited for this study. Inclusion Criteria was age > 41 years and patients diagnosed with primary open/closed angle glaucoma and cataract. Patients with secondary glaucoma, history of trabeculectomy and any other ocular diseases were excluded from the study. Pre-operative assessment was done for phacoemulsification. In post-operative examination, first and second follow-up IOP was measured. Data analysis was done on statistical package for social science (SPSS) version 20.0. Statistical changes were present in the form of bar chart, frequency and graphs. The mean standard deviation for pre-operative, post-operative 1st and 2nd follow-up IOP was calculated. Results:  A total of 38 participants and 48 eyes satisfied the inclusion criteria. Out of 48 eyes, 39 (81.3%) eyes were diagnosed with Primary open angle glaucoma and 9 (18.8%) eyes with Primary Angle Closure Glaucoma. The pre-operative mean IOP was 16.56 ± 6.67 mm Hg and post-operative mean IOP at first follow-up was 13.39 ± 4.04 mm Hg. At second follow-up at one-month mean IOP was 12.14 ± 2.28 mm Hg. Conclusion:  Phacoemulsification produces a useful decrease in IOP in glaucoma patients. Key Word:  Glaucoma, Cataract, Phacoemulsification, Intraocular Pressure.

scholarly journals Managing Primary Angle Closure Glaucoma – The Role of Lens Extraction in this Era

2016 ◽  
Vol 10 (1) ◽  
pp. 86-93 ◽  
Author(s):  
Nafees Baig ◽  
Ka-Wai Kam ◽  
Clement C.Y. Tham
Keyword(s):  
Gold Standard ◽  
Open Angle Glaucoma ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Predisposing Factor ◽  
Lens Extraction ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Anterior Position

Trabeculectomy has been the gold standard in reducing intraocular pressure (IOP) in glaucoma patients, no matter it is angle closure or open angle glaucoma. However in primary angle closure glaucoma, no matter the lens is cataractous or not, it is likely to be pathological, this thicker than usual lens, with or without a more anterior position, is often regarded as a strong contributing factor to angle closure. Lens extraction, no matter it is cataractous or clear, can theoretically eliminate this anatomical predisposing factor of angle closure, and thus IOP can be reduced. Based on recent results of a number of clinical trials, lens extraction alone or in combination with other IOP-lowering surgeries, may therefore play a more important role in the treating primary angle closure glaucoma. In cases when greater IOP-lowering effect is needed or if drug dependency has to be minimized, combined procedures, such as phacotrabeculectomy, can be considered, but the surgical risk can be higher than lens extraction alone.

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